title: Impact of chloroquine on viral load in breast milk.
abstract: The anti-malarial agent chloroquine has activity against HIV. We compared the effect of chloroquine (n = 18) to an anti-malarial agent without known anti-HIV-activity, sulfadoxine-pyrimethamine (n = 12), on breast milk HIV RNA levels among HIV-infected breastfeeding women in Zambia. After adjusting for CD4 count and plasma viral load, chloroquine was associated with a trend towards lower levels of HIV RNA in breast milk compared with sulfadoxine-pyrimethamine (P = 0.05). Higher breastmilk viral load was also observed among women receiving presumptive treatment for symptomatic malaria compared with asymptomatic controls and among controls reporting fever in the prior week. Further research is needed to determine the potential role of chloroquine in prevention of HIV transmission through breastfeeding.
authors.affiliation: Center for International Health & Development, Boston University School of Public Health, Boston, MA 02118, USA. ksemrau@bu.edu
authors.forename: Katherine
authors.initials: K
authors.lastname: Semrau
authors.forename: Louise
authors.initials: L
authors.lastname: Kuhn
authors.forename: Prisca
authors.initials: P
authors.lastname: Kasonde
authors.forename: Moses
authors.initials: M
authors.lastname: Sinkala
authors.forename: Chipepo
authors.initials: C
authors.lastname: Kankasa
authors.forename: Erin
authors.initials: E
authors.lastname: Shutes
authors.forename: Cheswa
authors.initials: C
authors.lastname: Vwalika
authors.forename: Mrinal
authors.initials: M
authors.lastname: Ghosh
authors.forename: Grace
authors.initials: G
authors.lastname: Aldrovandi
authors.forename: Donald M
authors.initials: DM
authors.lastname: Thea
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D000962:Antimalarials / Q000627:therapeutic use*; D001942:Breast Feeding; D018791:CD4 Lymphocyte Count; D002738:Chloroquine / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008288:Malaria / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D008895:Milk, Human / Q000187:drug effects / Q000821:virology*; D011739:Pyrimethamine / Q000627:therapeutic use; D012367:RNA, Viral / Q000032:analysis; D013413:Sulfadoxine / Q000627:therapeutic use; D019562:Viral Load; D015024:Zambia / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents; D000962:Antimalarials; D004338:Drug Combinations; D012367:RNA, Viral; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D002738:Chloroquine; D011739:Pyrimethamine