A presença na criança nascida de mãe infectada pelo VIH dos anticorpos maternos obtidos por transferência transplacentária, que podem persistir até aos 18 meses, invalida o diagnóstico de infecção da criança abaixo desta idade, se baseado apenas na sua seropositividade. É pois indispensável recorrer à execução de exames virológicos para diagnóstico, os quais são habitualmente realizados nas primeiras 48 horas de vida - se positivo indica transmissão do VIH in utero, aos 14-21 dias, 1-2 meses e 3-4 meses.
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Considera-se que a criança com exposição perinatal ao VIH está infectada se tiver dois exames virológicos positivos - cultura vírica e/ou reacção em cadeia da polimerase (PCR) do ADN ou do ARN do VIH.
A criança é considerada como não estando infectada quando estes exames virológicos são negativos, tendo pelo menos um deles sido realizado após os 4 meses de idade.
Após os 18 meses de idade, apenas a criança infectada apresenta anticorpos detectados por métodos imunoenzimáticos (EIA), com confirmação por imunofluorescência (IFA) ou por Western blot (WB).
A criança, entre os 6-18 meses, com dois exames serológicos negativos ou, maior de 18 meses, seronegativa, na ausência de hipogamaglobulinemia ou de outra evidência clínica ou laboratorial de infecção pelo vírus, não está infectada pelo VIH.
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