Non-antiretroviral Approaches to Prevention of Breast Milk Transmission of HIV-1: Exclusive Breastfeeding, Early Weaning, Treatment of Expressed Breast Milk
Identification of risk factors for breast milk transmission of HIV has led to the development of interventions to prevent such transmission . Mixed feeding of an infant, i.e., provision of other fluids and/or solids to the infant in addition to breast milk, has been associated with an increased r...
|Published in:||Human Immunodeficiency Virus type 1 (HIV-1) and Breastfeeding Vol. 743; pp. 197 - 204|
|Main Author:||Read, Jennifer S|
Advances in Experimental Medicine and Biology
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Identification of risk factors for breast milk transmission of HIV has led to the development of interventions to prevent such transmission . Mixed feeding of an infant, i.e., provision of other fluids and/or solids to the infant in addition to breast milk, has been associated with an increased risk of mother-to-child transmission of HIV [2, 3]. Therefore, exclusive breastfeeding of the infant has been emphasized, not only for the benefits such feeding provides to infants in general [4–7], but also specifically to prevent mother-to-child transmission of HIV . The longer the duration of exposure to breast milk from an HIV-infected woman, the greater the transmission of HIV to the infant . Although complete avoidance of breastfeeding has been shown to be efficacious in preventing breast milk transmission of HIV , such an intervention is not feasible in many settings. Therefore, the concept of early weaning from breastfeeding was developed, and this intervention has been evaluated . The higher the maternal HIV RNA concentration (viral load), including viral load in breast milk, the greater the HIV transmission to the infant [12–15]. Treatment of expressed breast milk with microbicidal agents or with heat to decrease breast milk viral load, and thus decrease mother-to-child transmission of HIV, has been evaluated [16, 17]. This chapter reviews these three approaches to the prevention of breast milk transmission of HIV: exclusive breastfeeding, early weaning, and treatment of expressed breast milk.