A woman at 41 weeks’ gestation presented to our hospital in December, 2009, in labor. She had a history of intravenous drug use, and was unaware of her HIV status. Rapid HIV-1 testing was positive and she had high viral load.

A small-for-gestational-age boy was delivered vaginally, in good condition. 12 h after his birth virological analyses, comprising HIV 1-2 antibody western blot (gag, pol, env) and HIV-1 antigen p24, were positive, and his HIV-RNA viral load was 152 560 copies per mL.

We started prophylaxis with zidovudine and nevirapine within 12 h of birth, but at day 4 his viral load was 13 530 copies per mL. After checking for possible viral resistance we started triple antiretroviral therapy with ritonavir boosted lopinavir, zidovudine, and lamivudine.

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