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 [1]. 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...

Full description

Published in: Human Immunodeficiency Virus type 1 (HIV-1) and Breastfeeding Vol. 743; pp. 197 - 204
Main Author: Read, Jennifer S
Format: Book Chapter
Language: English
Published: Boston, MA Springer US 2012
Edition: 2012
Series: Advances in Experimental Medicine and Biology
Subjects:
Online Access: Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Summary: Identification of risk factors for breast milk transmission of HIV has led to the development of interventions to prevent such transmission [1]. 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 [8]. The longer the duration of exposure to breast milk from an HIV-infected woman, the greater the transmission of HIV to the infant [9]. Although complete avoidance of breastfeeding has been shown to be efficacious in preventing breast milk transmission of HIV [10], 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 [11]. 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.
ISBN: 9781461422501
1461422507
DOI: 10.1007/978-1-4614-2251-8_14