Prevention of human immunodeficiency virus-1 transmission to the infant through breastfeeding: new developments.
Breastfeeding accounts for up to half of all infant human immunodeficiency virus (HIV) infections worldwide and carries an estimated transmission risk of about 15% when continued into the second year of life. Because replacement feeding is not safely available, culturally acceptable, or affordable in many parts of the world and because breastfeeding provides protection against other causes of infant mortality, approaches that reduce breastfeeding mother-to child transmission of HIV are being explored. These include exclusive breastfeeding for the infant's first few months of life followed by rapid weaning, treatments of expressed milk to inactivate the virus, and antiretroviral prophylaxis taken by the infant or mother during breastfeeding, which are strategies currently being tested in clinical trials. Passive (antibodies) and active (vaccine) immunoprophylaxis will also soon begin to be tested. This paper focuses on current and planned research on strategies to prevent breastfeeding transmission of HIV.
Kourtis
Athena P
AP
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA. apk3@cdc.gov
Jamieson
Denise J
DJ
de Vincenzi
Isabelle
I
Taylor
Allan
A
Thigpen
Michael C
MC
Dao
Halima
H
Farley
Timothy
T
Fowler
Mary Glenn
MG
D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D001942:Breast Feeding / Q000009:adverse effects; D005260:Female; D015658:HIV Infections / Q000628:therapy / Q000635:transmission*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000628:therapy; D013997:Time Factors; D014886:Weaning