Two cases of HIV transmission through breastfeeding in mothers with undetectable viral load reported | 12/6/2018 | Staff
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Two cases of HIV transmission from mother to infant during the breastfeeding period when mothers had an undetectable viral load have been reported by PROMISE, a large international study of the effectiveness of antiretroviral treatment in preventing vertical HIV transmission.

The findings were presented in a poster at the 22nd International AIDS Conference in Amsterdam in July.

Year - Group - Researchers - Research - HIV

Earlier this year an international group of researchers called for more research to determine if HIV can be transmitted through breast milk even if the breastfeeding mother has an undetectable viral load in blood. Swiss doctors have argued that pregnant women with HIV should be informed of the uncertain evidence about the risk of transmission during breastfeeding, and rather than being prohibited from breastfeeding while taking antiretroviral drugs, should be supported to breastfeed safely through regular viral load testing and education about factors that might increase the risk of transmission, such as mastitis.

The PROMISE study was a large international study conducted in 14 low- and middle-income countries, investigating the effectiveness of maternal antiretroviral therapy in preventing HIV transmission and its impact on maternal health. The study recruited women with CD4 cell counts above 350 cells/mm3 and randomised participants at three time-points: before delivery, after delivery during the breastfeeding period (postpartum), or after breastfeeding was discontinued.

Postpartum - Randomisation - Pairs - Therapy - Prophylaxis

In the postpartum randomisation, 2431 mother-infant pairs were randomised to either maternal antiretroviral therapy or infant prophylaxis with nevirapine during the breastfeeding period, beginning 6-14 days after delivery. All infants in the antiretroviral therapy arm also received daily nevirapine prophylaxis for six weeks after delivery, as recommended in World Health Organization guidelines. Mothers randomised to the infant prophylaxis arm were offered antiretroviral therapy after the results of the START study were announced in 2015.

Maternal viral load was tested at study entry and at weeks 6, 14, 26 and 50 weeks postpartum....
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