New York —
Findings showed that 77 percent of the women who had stopped breastfeeding at four months had detectable levels of HIV in their breast milk compared with 40 percent of those who were still exclusively breastfeeding at 4 1/2 months. Women who supplemented their breastfeeding after four months with other fluids and foods had higher HIV concentrations in their breast milk than those who were exclusively breastfeeding, though the level was lower than those who had weaned, the study found.
At the time of the study, antiretroviral drugs weren't available for the treatment of advanced HIV in sub-Saharan Africa, she said. When they were available, they were only used around the time of delivery and not recommended for use during breastfeeding. Women could choose to breastfeed and risk passing along the virus to their child or they could not breastfeed, which would leave their baby at a higher risk of infectious diseases like pneumonia and diarrhea.
"Fortunately since such time as we conducted the research, antiretroviral drug regimens have now been shown to be highly effective to prevent transmission through breastfeeding," she said. "Governments should support the roll-out of programs to make antiretroviral drugs available for HIV-positive women who are pregnant and who are breastfeeding."
Antiretroviral treatments include Johnson & Johnson's Prezista, Gilead Sciences Inc.'s Truvada, Bristol-Myers Squibb Co.'s Sustiva, GlaxoSmithKline Plc's Ziagen and Abbott Laboratories's Kaletra.
In 2010, the World Health Organization updated its breast- feeding guidelines for HIV-positive women to recommend that each country decide which infant feeding practice they want to promote, including whether antiretroviral drugs be used to reduce the transmission of the virus during breastfeeding or breastfeeding be avoided.
The WHO guidelines suggest that where HIV treatments are used, mothers should breastfeed their infants to at least 12 months. And if antiretroviral drugs are unavailable, women can still breastfeed for at least the first six months.
The U.S. Centers for Disease Control and Prevention advises HIV-positive women not to breastfeed their infants even if they are taking antiretroviral drugs.