TORCH Panel
Newborns who have certain symptoms or who are born to mothers who may have been exposed to certain
pathogens may be screened for toxoplasmosis,
rubella,
cytomegalovirus, and
herpes simplex virus. These four tests also may be run as a panel known as a
TORCH screen. Newborns may be screened for other infections, such as
syphilis,
hepatitis B, enterovirus,
Epstein-Barr virus, varicella-zoster virus, and human parvovirus.
HIV Testing
In the United States, newborns are likely to be screened for HIV infection if their mothers were not tested when they were pregnant (see HIV Screening during Pregnancy). Human immunodeficiency virus is the virus that causes AIDS (acquired immunodeficiency syndrome). The infection can pass from an infected mother to her child during birth (when exposed in the birth canal to the mother’s secretions and blood) or during breastfeeding (when the infant drinks breast milk containing the virus).
More than 90% of all AIDS cases in children in the United States came from the mother during pregnancy. In 2005, about 142 children were infected with HIV from their mothers in this country, reported the U.S. Centers for Disease Control and Prevention. If a mother with HIV does not receive treatment during the pregnancy, the child has a 1 in 4 chance of getting AIDS. With timely treatment, fewer than 2% of children of infected mothers get the disease.
Thanks to aggressive screening and early intervention, the United States has seen a steady decline in new AIDS cases in children. The best way to protect the child’s health is to detect the HIV infection during pregnancy, treat the mother with medication, and make birthing plans to help the baby avoid infection. If the mother was not tested during pregnancy or childbirth, the newborn can be screened and treated shortly after birth. HIV testing has become routine prenatal care in this country; some states even require that all pregnant women or their newborns be tested.
Screening the mother: All pregnant women in the United States should be counseled about HIV early in their pregnancy and receive voluntary HIV testing to protect the child’s health. This is the recommendation of many groups, including the U.S. Public Health Service, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, and U.S. Preventive Services Task Force.
Screening the baby: In the United States, if the mother’s HIV status is not determined before or during pregnancy or during labor and delivery, health care providers recommend that the newborn be given an HIV test within 24 hours of the birth (in a few states, this is a requirement). Treatment begun within 48 hours of birth helps prevent a baby who was exposed to the virus from becoming infected.
Links
New Mexico AIDS InfoNet: Fact sheet 611 on “Pregnancy and HIV”
The Well Project (information for HIV-positive women who are pregnant or planning a pregnancy)
Sources
S1
US Centers for Disease Control and Prevention. HIV/AIDS topics: pregnancy and childbirth. Last modified 10 Oct 2007. Available on the internet through http://www.cdc.gov. Accessed 27 Nov 2007.
S2
US Centers for Disease Control and Prevention. One test, two lives: prenatal HIV screening benefits mom and baby. Last modified 1 May 2007. Available on the internet through http://www.cdc.gov. Accessed 27 Nov 2007.
S3
Working Group on Antiretroviral Therapy and Medical Management of HIV-Infected Children, National Institutes of Health. Guidelines for the use of antiretroviral agents in pediatric HIV Infection. 25 Oct 2006. PDF available for download at http://www.aidsinfo.nih.gov. Accessed 27 Dec 2007.
S4
King SM et al. Evaluation and treatment of the human immunodeficiency virus-1—exposed infant. Aug 2004. Pediatrics 114;2:497-505.
S5
New Mexico AIDS InfoNet, New Mexico AIDS Education and Training Center, University of New Mexico Health Sciences. Fact sheet 611, Pregnancy and HIV (2 May 2004), and Fact sheet 102, HIV Testing (5 Aug 2004). Available on the internet through http://www.aidsinfonet.org. Accessed 27 Nov 2007.
