A trial that was recently published in The Lancet confirmed WHO guidelines for ARVs with HIV positive mothers. The study showed that prevention of mother-to-child transmission of HIV (PMTCT) was more effective when women were given triple drug ART, zidovudine, lamivudine, and ritonavir-boosted lopinavir (Kaletra) twice daily until the end of breastfeeding, than when women were given standard drug prophylaxis, zidovudine (AZT) twice daily until delivery, a dose of zidovudine plus nevirapine (3TC) at the onset of labor, and a week of postpartum zidovudine and lamivudine twice daily.
A year after birth, children of mothers receiving three drug therapy were 43% less likely to have HIV than children who only received standard prophylaxis. This study confirms the effectiveness of the 2009 WHO guidelines for pregnant and breastfeeding women, that they should receive triple prophylaxis starting in the second trimester and should continue until breastfeeding is completely ended.
http://www.medpagetoday.com/HIVAIDS/HIVAIDS/24327
Hannah Harrison
Breastfeeding in the context of HIV MTCT is such a controversial topic, but I'm glad about the findings of this study because I do support exclusive breastfeeding (as opposed to mixed, which is what greatly increases the risk of HIV MTCT). Children at risk of HIV are more likely to die of diarrheal diseases if having formula milk than they are of contracting HIV.
ReplyDeleteAhhh! Laura we totally talked about this in Global Public Health last year!! I think Bonnie Maldonado was discussing it during her guest lecture (are you in her class with Yu-Jin?).
ReplyDelete-Autumn