Related Experiment Video
Updated: Jun 8, 2026
08:12
Isolation of Leukocytes from Human Breast Milk for Use in an Antibody-dependent Cellular Phagocytosis Assay of HIV Targets
Published on: September 6, 2019
Maternal HIV viral load threshold for guiding extended infant prophylaxis.
Jean-Pierre Molès1, Morgana D'Ottavi1, David Rutagwera2
1Pathogenesis and Control of Chronic and Emerging Infections, Montpellier University, INSERM, CHU Montpellier, 34493 Montpellier France.
The Journal of Infection
|June 6, 2026
Summary
A single maternal viral load (mVL) test at 6-8 weeks can identify infants needing extended HIV prophylaxis. A lower threshold of 40 cp/mL is more effective than the standard 1000 cp/mL for risk stratification.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Infant postnatal prophylaxis (PNP) is crucial for breastfed infants born to mothers with HIV.
- Extended PNP is recommended for high-risk infants, but identifying these infants can be challenging.
Purpose of the Study:
- To evaluate if a single maternal viral load (mVL) measurement at the end of universal PNP can accurately identify infants requiring extended prophylaxis.
- To determine an optimal mVL threshold for risk stratification.
Main Methods:
- Assessed 1398 maternal viral loads (VL) at 6-8 weeks, 6 months, and 12 months postpartum in Zambia and Burkina Faso.
- Defined infants as high-risk for HIV acquisition if maternal VL was ≥ 1000 cp/mL.
Main Results:
- Mothers with mVL ≥ 40 cp/mL at baseline were significantly more likely to have elevated VL during breastfeeding.
- A 40 cp/mL threshold demonstrated superior performance in identifying infants eligible for extended PNP compared to the standard 1000 cp/mL threshold.
Conclusions:
- A single mVL at 6-8 weeks effectively identifies infants at risk of HIV acquisition throughout breastfeeding.
- This finding supports a simplified, risk-stratified guideline for extended infant PNP initiation.
