Paediatric infections: HIV-exposed infant testing: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Paediatric infections: HIV-exposed infant testing

Sample item

A 6-week-old infant born to an HIV-positive mother has a positive DNA PCR test. What is the recommended action?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Start antiretroviral therapy immediately after confirming with a repeat test, without waiting for clinical staging

HIV DNA PCR is done at 6 weeks in exposed infants, and a positive result is confirmed on a second sample. All infected infants start ART as soon as possible irrespective of clinical stage or CD4, along with cotrimoxazole prophylaxis.

Option by option

  • A. Delay ART until CD4 falls below 25 percent

    Treat-all policy means CD4 thresholds are no longer used.

  • B. Wait until 18 months for antibody testing before treatment

    Antibody tests are unreliable under 18 months because of maternal antibodies, and waiting is harmful.

  • C. Start antiretroviral therapy immediately after confirming with a repeat test, without waiting for clinical staging (correct)

    Correct. Early ART improves survival.

  • D. Give cotrimoxazole only

    Cotrimoxazole alone does not treat HIV.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is C, Start antiretroviral therapy immediately after confirming with a repeat test, without waiting for clinical staging. HIV DNA PCR is done at 6 weeks in exposed infants, and a positive result is confirmed on a second sample.

Why is "Delay ART until CD4 falls below 25 percent" not the answer?

Treat-all policy means CD4 thresholds are no longer used.

Why is "Wait until 18 months for antibody testing before treatment" not the answer?

Antibody tests are unreliable under 18 months because of maternal antibodies, and waiting is harmful.

Why is "Give cotrimoxazole only" not the answer?

Cotrimoxazole alone does not treat HIV.

What concept does this question test?

It tests Paediatric infections: HIV-exposed infant testing in Pediatrics. All infected infants start ART as soon as possible irrespective of clinical stage or CD4, along with cotrimoxazole prophylaxis.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric infections: HIV-exposed infant testing?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.