Newborn prophylaxis with combination antiretroviral therapy should begin approximately how soon after birth?

• A. 6 to 12 hours after birth
• B. 24 to 48 hours after birth
• C. 1 week after birth
• D. At birth only

Answer: (A)

Starting newborn prophylaxis with combination antiretroviral therapy as soon as possible, ideally within 6 to 12 hours after birth, is essential because perinatal HIV exposure can lead to rapid viral establishment in the newborn around the time of delivery. Attaining therapeutic drug levels quickly helps prevent the virus from taking hold in neonatal cells. Delaying to 24–48 hours or later decreases effectiveness and increases transmission risk, and waiting until a week after birth is far too late. Beginning within 6–12 hours provides the best chance to minimize vertical transmission.