Antiretroviral Therapy Among HIV-Infected Breastfeeding Mothers: A Promising Strategy to Prevent HIV Postnatal Transmission in Africa

Abstract

Evaluation of: Giuliano M, Guidotti G, Andreotti M et al.: Triple antiretroviral prophylaxis administered during pregnancy and after delivery significantly reduces breast milk viral load: a study within the Drug Resource Enhancement Against AIDS and Malnutrition Program. J. Acquir. Immune Defic. Syndr. 44(3), 286–291 (2007). Maternal highly active antiretroviral therapy (HAART) starting during the late prenatal period and prolonged during lactation is a potentially interesting strategy to prevent mother-to-child transmission of HIV through breastfeeding in Africa. In this report, Giuliano and colleagues demonstrated that HIV-infected women treated with HAART from before delivery had lower cell-free HIV RNA load in breast milk and were less likely to have a detectable viral load in this compartment 1 week after delivery, when compared with untreated women. Antiretroviral therapy among HIV-infected breastfeeding mothers could thus be a promising strategy to prevent HIV transmission through breast milk in Africa if further larger studies confirm its safety. This strategy could also provide a link between prevention and care, since maternal HAART provided in pregnancy and during the breastfeeding period can be thereafter continued among women who meet the criteria for their own health.