Does breast-feeding delay progression to AIDS in HIV-infected children?

Abstract

Researchers gathered data from the National Registry of AIDS in Italy to examine the effect breast feeding has on the incubation time for AIDS in 117 vertically infected children. 36 children received breast milk and 64 were bottle fed. No perinatal feeding data existed in the registry for the remaining 17 children. There was a significant difference between the median incubation periods for the 36 breast fed (19 months) and 64 bottle fed (9.7 months) children (p=.003). An overlap in the incubation curves took place shortly before 60 months however. Further the breast fed children had a longer survival rate than the bottle fed children (Breslow p=.01; Mantel-Cox p=.003). From 198 when the 1st case occurred to 1986 breast feeding and bottle feeding patterns remained stable but beginning in 1987 the frequency of breast feeding declined significantly (p<.05). Limitations of the registry data included no information was recorded on potential confounding factors duration of breast feeding and mothers clinical conditions. For example perhaps asymptomatic HIV positive mothers tended to breast feed their children more so than mothers who had full blown AIDS or AIDS related complex. In addition since there were no data on duration of breast feeding the researchers could not determine a dose response effect. Nevertheless the results of this study suggest that breast feeding does postpone the development of AIDS in children. Researchers need to conduct prospective studies to confirm or deny these tentative results. The value of breast feeding and time of weaning will increase if indeed future studies prove that breast feeding does delay development of AIDS.