Neonatal Nurse Practitioner Practice Exam

Definitive diagnosis of HIV infection in a neonate born to an HIV-positive mother requires?

1. Detection of HIV-specific nucleic acid

2. Enzyme linked immunosorbent assay (ELISA)

3. Viral load assays

4. Serological testing for antibodies

The correct answer is: Detection of HIV-specific nucleic acid

The definitive diagnosis of HIV infection in a neonate born to an HIV-positive mother hinges on the detection of HIV-specific nucleic acid. In neonates, maternal antibodies from the mother can persist for several months after birth, which can complicate the interpretation of serological tests. Standard antibody tests like the enzyme-linked immunosorbent assay (ELISA) are not definitive in this context because the antibodies detected could be from the mother rather than indicative of the infant’s own infection. Viral load assays, while useful for monitoring viral replication in individuals already diagnosed with HIV, are not the definitive method for confirming initial infection in a neonate. Detecting HIV-specific nucleic acid, such as through polymerase chain reaction (PCR) testing, allows for the identification of the virus itself and confirms the diagnosis independent of maternal antibodies. This method is critical because it establishes the presence of the virus in the neonate, ensuring that any subsequent treatment and management can be appropriately addressed.