A Case of Delayed Detection of Vertical Transmission of HIV-1 Due to Maternal Therapy With Long-Acting Injectable Cabotegravir Plus Rilpivirine.
Cornelia Feiterna-Sperling, Eva Albers, Irena Rohr et al.
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Case in brief
A 4-month-old infant was diagnosed with HIV-1 after in utero exposure to maternal antiretroviral therapy with long-acting injectable cabotegravir plus rilpivirine (LA-CAB/RPV) during the third trimester. The report describes delayed detection of vertical transmission in this setting. The authors note that prolonged viral suppression in infants infected after maternal LA-CAB/RPV exposure may delay diagnosis, and that molecular testing beyond 3 months of age may be needed to exclude infection.
What made this case unusual
Maternal LA-CAB/RPV exposure was associated with delayed detection of infant HIV-1, with prolonged viral suppression identified as a potential diagnostic challenge.
Diagnostic / clinical pearl
After maternal LA-CAB/RPV exposure, a negative early assessment may not exclude infant HIV-1; molecular testing beyond 3 months of age may be needed.