title: Use of antiretroviral drugs to prevent HIV-1 transmission through breast-feeding: from animal studies to randomized clinical trials.
abstract: The major remaining challenge in the prevention of mother-to-child transmission is the reduction of the risk in settings where breast-feeding is common. This review gives an update on ongoing or planned antiretroviral intervention studies in resource-limited settings that are aimed at reducing the risk of mother-to-infant HIV transmission during lactation. These strategies include antiretroviral therapy given to the mother to reduce viral load in plasma and breast milk as well as antiretroviral regimens providing prophylaxis to uninfected infants during the period of breast-feeding. The rationale for the interventions based on animal models and human studies is described as well as the study designs of clinical trials. Potential risks and benefits of these interventions to mothers and infants are also highlighted. Laboratory studies nested within several of these trials will provide a better understanding of the pathogenesis of postnatal HIV transmission and its potential prevention using antiretroviral drugs.
authors.affiliation: World Health Organization, Reproductive Health and Research, Geneva, Switzerland.
authors.forename: Philippe
authors.initials: P
authors.lastname: Gaillard
authors.forename: Mary-Glenn
authors.initials: MG
authors.lastname: Fowler
authors.forename: Francois
authors.initials: F
authors.lastname: Dabis
authors.forename: Hoosen
authors.initials: H
authors.lastname: Coovadia
authors.forename: Charles
authors.initials: C
authors.lastname: Van Der Horst
authors.forename: Koen
authors.initials: K
authors.lastname: Van Rompay
authors.forename: Andrea
authors.initials: A
authors.lastname: Ruff
authors.forename: Taha
authors.initials: T
authors.lastname: Taha
authors.forename: Tim
authors.initials: T
authors.lastname: Thomas
authors.forename: Isabelle
authors.initials: I
authors.lastname: De Vincenzi
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Newell
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control* / Q000635:transmission*; D000818:Animals; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001942:Breast Feeding / Q000009:adverse effects*; D004195:Disease Models, Animal; D005260:Female; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008892:Milk / Q000821:virology*; D008895:Milk, Human / Q000821:virology*; D016032:Randomized Controlled Trials as Topic
chemical_list: D019380:Anti-HIV Agents