HIV transmission via breast milk in Ugandan women limited

HIV infected women in developing countries should not be discouraged from breast feeding, according to a multicenter team led by Dr. Laura A. Guay at University Hospitals of Cleveland, Ohio. According to a study published in a recent issue of Pediatrics, Guay reported results of a study of Ugandan women that found "...no correlation...between the detection of HIV-1 in breast milk or the duration of breast feeding and transmission of HIV-1 infection." (Pediatrics 1996; 98:438-444). Specifically, Guay's team "...did not detect p24 antigen in any of [the] breast milk specimens...including the breast milk from 43 transmitter mothers and 82 mothers with HIV-1 DNA present by PCR in the same specimen.... This suggests that there is little replication and free p24 antigen production in breast milk supernatants." In their ongoing study, Guay and colleagues are prospectively following a group of Ugandan women infected with HIV-1 before delivery and their infants. They cautioned that "...the situation of an already infected mother is different from the case of the postnatally infected mother where the ability of a child to be infected through breast milk is well-documented." The researchers emphasize that these data "...should be viewed as strongly suggestive, rather than proven." Guay concluded that public health efforts in developing countries should focus more on preventing seronegative breast-feeding women from contracting HIV than on preventing HIV positive women from breast feeding.