**Question:** A term infant is born to a known HIV-positive mother. She has been taking antiretroviral medications for the weeks prior to the delivery of her infant. Routine management of the healthy infant should include

A. HIV testing
B. Prophylactic antiretroviral therapy (ART)
C. Antibiotic prophylaxis
D. Hepatitis B vaccine

**Correct Answer:** C. Antibiotic prophylaxis

**Core Concept:**

Infants born to HIV-positive mothers require specific management due to the risk of vertical transmission (mother-to-child transmission) of HIV. Antiretroviral medications (ART) are used to reduce the risk of transmission, but the focus here is on the routine management of the healthy infant. Antibiotic prophylaxis is important to prevent sepsis, which is a common complication in infants.

**Why the Correct Answer is Right:**

The correct answer, **Antibiotic prophylaxis**, is essential for infants born to HIV-positive mothers. Antiretroviral therapy (ART) is aimed at the mother to reduce the risk of transmission, not for the infant's wellbeing. Antibiotic prophylaxis is crucial to prevent sepsis, which is a significant risk in infants, especially in this context due to the potential exposure to HIV.

**Why Each Wrong Option is Incorrect:**

**A.** HIV testing is specific to HIV diagnosis, not routine infant management.

**B.** Prophylactic antiretroviral therapy (ART) is meant for the mother to reduce transmission risk, not the infant.

**D.** Hepatitis B vaccine is important for Hepatitis B prevention but is unrelated to the specific needs of an infant born to an HIV-positive mother.

**Clinical Pearls:**

1. HIV-positive mothers often receive ART to reduce transmission risk, but the focus here is on the healthy infant.
2. Antibiotic prophylaxis is essential for infants born to HIV-positive mothers to prevent sepsis, which is common in this population.
3. HIV testing is for diagnosis, not management of a healthy infant.
4. ART is meant for the mother to prevent transmission, not the infant.
5. Hepatitis B vaccine is unrelated to the specific needs of an infant born to an HIV-positive mother.