Quiz 4: HIV in the newborn infant

Choose the one, most correct answer to each question or statement.

1. How may HIV be transmitted from a woman to her newborn infant?
   • By touching the infant
   • By kissing the infant
   • By breastfeeding the infant
   • By hugging the infant
2. HIV infection during pregnancy commonly causes:
   • Stillbirth
   • Congenital abnormalities
   • Clinical signs of HIV infection in the infant at birth
   • No sign of infection in the newborn infant
3. HIV infection in the newborn infant is confirmed if the following test is positive:
   • TPHA
   • VDRL
   • Rapid HIV test
   • PCR
4. When can a rapid test be used to diagnose HIV infection in an infant?
   • At 18 months of age
   • At one year of age
   • At three months of age
   • At birth
5. Infants who are infected with HIV during labour or delivery usually present with clinical signs of infection:
   • During the first month of life
   • Between one and three months of age
   • Between three and six months of age
   • After six months of age
6. Which HIV exposed infants should have NVP at birth?
   • All HIV exposed infants
   • Only if the mother did not receive ARV treatment
   • Only if maternal ARV treatment started in the last month of pregnancy
   • Only if the mother received ARV treatment from 14 weeks
7. What is the added risk of HIV infection if the mother and infant are taking ARV drugs correctly and exclusively breastfeeding for 6 months?
   • 10%
   • 5%
   • 0.3%
   • 0%
8. HIV can be transmitted through the breast milk:
   • At any time that the infant is still breastfed
   • Only during the first few days when the mother is producing colostrum
   • Only while the infant is exclusively breastfed
   • Only if the infant has oral thrush
9. What factors may increase the risk of HIV transmission by breast milk?
   • Prolonged suckling during a feed
   • Engorged breasts
   • Puerperal sepsis with fever
   • A breast abscess with the previous infant
10. If the PCR test of breastfeeding infant is negative at 10 weeks, when should a repeat test be done?
    • Following a further 3 months of breastfeeding
    • At 6 months
    • Six weeks after the last feed of breast milk
    • At 18 months
11. What method of infant feeding should be used by mothers living with HIV?
    • They should all exclusively breastfeed for three months followed by rapid weaning
    • They should only feed their infants with formula milk.
    • They should exclusively breastfeed for six months followed by extended breastfeeding once solids are started
    • They should supplement breastfeeding with formula milk
12. For how long should a healthy woman living with HIV on ARV prophylaxis breastfeed if the infant’s PCR at 10 weeks was negative?
    • They should exclusive breastfeed followed by rapid weaning at 3 months
    • They should exclusive breastfeed followed by rapid weaning at 6 months
    • They should continue breastfeeding followed by slow weaning at 9 months
    • They should continue breastfeeding for one year
13. How can HIV be killed in expressed breast milk?
    • By keeping the milk in a fridge for 24 hours
    • By pasteurisation
    • By allowing the milk to stand at room temperature for 6 hours
    • By adding multivitamin drops to the milk
14. Expressed breast milk to preterm infants who are not able to breastfeed yet should be given by:
    • Cup if possible
    • Nasogastric tube until term
    • Bottle when they are old enough to suck
    • Breast milk should not given to preterm infants as they are at high risk of becoming infected
15. What feeding advice should be given to HIV-negative women?
    • They should not breastfeed as they may still become infected with HIV.
    • They should only breastfeed for three months.
    • They should breastfeed for as long as possible.
    • It does not matter whether they breast or formula feed.
16. Which immunisations should be given to well infants born to women living with HIV?
    • All routine immunisations
    • Only dead vaccines such as DPT
    • Only BCG
    • None at all
17. What prophylactic drug should be given to all HIV-infected infants?
    • Penicillin
    • Isoniazid (INH)
    • Co-trimoxazole (Septran, Bactrim, Purbac)
    • Nystatin (Mycostatin)
18. What are the presenting signs of symptomatic HIV infection in a young infant?
    • They often develop cancer
    • Failure to thrive or weight loss
    • Vomiting and abdominal distension
    • Oedema and excessive weight gain
19. What infections are commonly seen in infants with HIV infection?
    • Measles
    • Gastroenteritis
    • Syphilis
    • Toxoplasmosis
20. Who should follow up a well infant born to a mother living with HIV?
    • A paediatrician at a level II or III hospital
    • A doctor at a special HIV clinic
    • A medical officer at a district hospital
    • A registered nurse at a primary-care clinic