Prevention of human immunodeficiency virus-1 transmission to the infant through breastfeeding: new developments

Athena P Kourtis1, Denise J Jamieson, Isabelle de Vincenzi

  • 1Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA. apk3@cdc.gov

Insights

Preventing mother-to-child HIV transmission during breastfeeding is crucial. Research explores strategies like exclusive breastfeeding, milk treatment, and antiretroviral prophylaxis to reduce infant infections globally.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Pediatrics

Background:

  • Breastfeeding is a major route for infant human immunodeficiency virus (HIV) transmission, accounting for up to 50% of infections globally.
  • The transmission risk via breastfeeding can reach 15% by the second year of life.
  • Safe, affordable, and culturally acceptable replacement feeding options are limited in many regions, making breastfeeding essential for infant survival.

Purpose of the Study:

  • To review current and planned research on strategies aimed at preventing HIV transmission from mother to child through breastfeeding.
  • To explore innovative approaches to mitigate the risks associated with breastfeeding in the context of HIV.

Main Methods:

  • Focus on strategies currently being tested in clinical trials.
  • Includes analysis of interventions such as exclusive breastfeeding with rapid weaning.
  • Examines viral inactivation of expressed breast milk and antiretroviral prophylaxis for mother or infant.

Main Results:

  • Multiple promising strategies are under investigation to reduce breastfeeding-related HIV transmission.
  • Antiretroviral prophylaxis and modified breastfeeding practices show potential for significant risk reduction.
  • Future research will include passive and active immunoprophylaxis.

Conclusions:

  • Reducing breastfeeding-associated HIV transmission is a critical global health priority.
  • A combination of approaches, including medical interventions and modified infant feeding practices, is likely necessary.
  • Ongoing research is vital to develop effective and accessible methods to protect infants from HIV through breastfeeding.

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