Preventing mother-to-child transmission of HIV during breastfeeding
New evidence published in Lancet Infectious Diseases shows safety and efficacy of combination antiretroviral drugs during pregnancy, delivery and breastfeeding and supports the 2010 revised WHO guidelines.
The Kesho Bora study ("A better future", Swahili) found that giving HIV positive mothers a combination of 3 antiretroviral drugs (ARVs) during pregnancy, delivery and breastfeeding cuts HIV infections in infants by 43% by the age of 1 year and reduces transmissions during breastfeeding by 54% compared with the previously recommended ARV drug regimen stopped at delivery.
The balance of risks and benefits of continuing ARVs during breastfeeding was not known prior to this study which was conducted in five sites in Burkina Faso, Kenya, and South Africa and coordinated by WHO's Department of Reproductive Health and Research.
This approach offers new hope for mothers with HIV infection who cannot safely feed their babies with infant formula. It will improve the chances of infants remaining healthy and free of HIV infection as breast milk provides optimal nutrition and protects against other fatal childhood diseases such as pneumonia and diarrhoea.
Giving HIV-positive pregnant women (and those planning pregnancy) priority access to ARVs will help eliminate mother-to-child transmission of HIV.