Antiretroviral Drugs During Breastfeeding for the Prevention of Postnatal Transmission of HIV-1

  • Athena P. Kourtis
  • Isabelle de Vincenzi
  • Denise J. Jamieson
  • Marc Bulterys
Chapter
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 743)

Abstract

The global pediatric human immunodeficiency virus (HIV) type 1 epidemic is fueled to a large extent by postnatal transmission from mother to infant through breastfeeding. As many as 90% of the estimated 430,000 new HIV infections in children less than 15 years of age in 2008 were due to mother-to-child transmission (MTCT) [1]. MTCT can occur in utero, intrapartum, or postpartum through breastfeeding; among children with known timing of infection, as much as 30–40% of MTCT of HIV-1 is attributable to breastfeeding; this proportion may be even higher in settings where effective interventions that decrease in utero and intrapartum transmission are being implemented [2–4].

References

  1. 1.
    UNAIDS. AIDS Epidemic Update: November 2009. http://data.unaids.org/pub/Report/2009/jc1700_epi_update_2009_en.pdf. Nov 24 2009, Geneva, Switzerland. Accessed 14 Dec 2010
  2. 2.
    Horvath T, Madi BC, Iuppa IM, Kennedy GE, Rutherford G, Read JS (2009) Interventions for preventing late postnatal mother-to-child transmission of HIV. Cochrane Database Syst Rev CD006734Google Scholar
  3. 3.
    Nduati R, John G, Mbori-Ngacha D et al (2000) Effect of breastfeeding and formula feeding on transmission of HIV-1: a randomized clinical trial. JAMA 283:1167–1174PubMedCrossRefGoogle Scholar
  4. 4.
    World Health Organization (2010) HIV transmission through breastfeeding: a review of available evidence. http://www.unfpa.org/upload/lib_pub_file/276_filename_HIV_PREV_BF_GUIDE_ENG.pdf. Accessed 20 Nov 2010
  5. 5.
    World Health Organization. Report of a WHO technical consultation on birth spacing. http://www.who.int/making­_pregnancy_safer/documents/birth_spacing.pdf. 15 Jun 2005. Accessed 20 Nov 2010
  6. 6.
    Jelliffe DB, Jelliffe EF (1978) Human milk in the modern world. Oxford University Press, New YorkGoogle Scholar
  7. 7.
    Achievements in public health (2006) Reduction in perinatal transmission of HIV infection – United States, 1985–2005. MMWR Morb Mortal Wkly Rep 55:592–597Google Scholar
  8. 8.
    World Health Organization (2010) Antiretroviral drugs for treating pregnant women and preventing HIV infection in infants. Recommendations for a public health approach. 2010 Version. http://www.who.int, Accessed: 15 Dec 2010.
  9. 9.
    Kuhn L, Aldrovandi GM, Sinkala M et al (2008) Effects of early, abrupt weaning on HIV-free survival of children in Zambia. N Engl J Med 359:130–141PubMedCrossRefGoogle Scholar
  10. 10.
    Kilewo C, Karlsson K, Ngarina M et al (2009) Prevention of mother-to-child transmission of HIV-1 through breastfeeding by treating mothers with triple antiretroviral therapy in Dar es Salaam, Tanzania: the Mitra Plus study. J Acquir Immune Defic Syndr 52:406–416.10Google Scholar
  11. 11.
    Kumwenda NI, Hoover DR, Mofenson LM et al (2008) Extended antiretroviral prophylaxis to reduce breast-milk HIV-1 transmission. N Engl J Med 359:119–12911PubMedCrossRefGoogle Scholar
  12. 12.
    Palombi L, Marazzi MC, Voetberg A, Magid NA (2007) Treatment acceleration program and the experience of the DREAM program in prevention of mother-to-child transmission of HIV. AIDS 21(Suppl 4):S65–S711PubMedCrossRefGoogle Scholar
  13. 13.
    Kesho Bora Study Group (2010) Eighteen month follow-up of HIV-1-infected mothers and their children enrolled in the Kesho Bora study observational cohorts. J Acquir Immune Defic Syndr 54:533–541Google Scholar
  14. 14.
    Taha T, Kumwenda J, Cole S et al (2009) Postnatal HIV-1 transmission after cessation of infant extended antiretroviral prophylaxis and effect of maternal highly active antiretroviral therapy. J Infect Dis 200:1490–1497PubMedCrossRefGoogle Scholar
  15. 15.
    Shapiro RL, Hughes M, Ogwu A et al (2010) Antiretroviral regimens in pregnancy and breast-feeding in Botswana. N Engl J Med 362:2282–2294PubMedCrossRefGoogle Scholar
  16. 16.
    Townsend CL, Cortina-Borja M, Peckham CS et al (2008) Low rates of mother to child transmission of HIV following effective pregnancy interventions in the United Kingdom and Ireland, 2000–2006. AIDS 22:973–981PubMedCrossRefGoogle Scholar
  17. 17.
    Nduati R, Richardson BA, John G et al (2001) Effect of breastfeeding on mortality among HIV-1 infected women: a randomised trial. Lancet 26(357):1651–1655CrossRefGoogle Scholar
  18. 18.
    Dabis F, Msellati P, Meda N et al (1999) 6-month efficacy, tolerance, and acceptability of a short regimen of oral zidovudine to reduce vertical transmission of HIV in breastfed children in Cote d’Ivoire and Burkina Faso: a double-blind placebo-controlled multicentre trial. DITRAME Study Group. DIminution de la Transmission Mere-Enfant. Lancet 353:786–792PubMedCrossRefGoogle Scholar
  19. 19.
    Guay LA, Musoke P, Fleming T et al (1999) Intrapartum and neonatal single-dose nevirapine compared with zidovudine for prevention of mother-to-child transmission of HIV-1 in Kampala, Uganda: HIVNET 012 randomised trial. Lancet 354:795–802PubMedGoogle Scholar
  20. 20.
    Connor EM, Sperling RS, Gelber R et al (1994) Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. N Engl J Med 331:1173–1180PubMedCrossRefGoogle Scholar
  21. 21.
    Cooper ER, Charurat M, Mofenson L et al (2002) Combination antiretroviral strategies for the treatment of pregnant HIV-1-infected women and prevention of perinatal HIV-1 transmission. J Acquir Immune Defic Syndr 29:484–494PubMedGoogle Scholar
  22. 22.
    Shaffer N, Chuachoowong R, Mock PA et al (1999) Short-course zidovudine for perinatal HIV-1 transmission in Bangkok, Thailand: a randomised controlled trial. Bangkok Collaborative Perinatal HIV Transmission Study Group. Lancet 353:773–780PubMedCrossRefGoogle Scholar
  23. 23.
    Wiktor SZ, Ekpini E, Karon JM et al (1999) Short-course oral zidovudine for prevention of mother-to-child transmission of HIV-1 in Abidjan, Cote d’Ivoire: a randomised trial. Lancet 353:781–785PubMedCrossRefGoogle Scholar
  24. 24.
    Bedri A, Gudetta B, Isehak A et al (2008) Extended-dose nevirapine to 6 weeks of age for infants to prevent HIV transmission via breastfeeding in Ethiopia, India, and Uganda: an analysis of three randomised controlled trials. Lancet 372:300–313PubMedCrossRefGoogle Scholar
  25. 25.
    ThomasT, Masaba, R, Ndivo, R, Kisumu Breastfeeding Study Team (2008) Prevention of mother-to-child transmission of HIV-1 among breastfeeding mothers using HAART: The Kisumu Breastfeeding Study, Kisumu, Kenya, 2003–2007. Abstract 45aLB. In: 15th Conference on retroviruses and opportunistic infections, Boston, MA. http://www.retroconference.org/2008/Abstracts/33397.htm. Accessed 20 Apr 2010
  26. 26.
    The Kesho Bora study Group (2010) Triple-antiretroviral compared with zidovudine and single-dose nevirapine prophylaxis during pregnancy and breastfeeding for prevention of mother-to-child transmission of HIV-1 (Kesho Bora study): a randomised controlled trial. Lan Infect Dis 2011;11(3):171–180Google Scholar
  27. 27.
    Chasela C, Hudgens M, Jamieson D et al (2010) Maternal or infant antiretroviral drugs to reduce HIV-1 transmission. N Engl J Med 362:2271–2281PubMedCrossRefGoogle Scholar
  28. 28.
    Giuliano M, Guidotti G, Andreotti M et al (2007) Triple antiretroviral prophylaxis administered during pregnancy and after delivery significantly reduces breast milk viral load: a study within the Drug Resource Enhancement Against AIDS and Malnutrition Program. J Acquir Immune Defic Syndr 44:286–291PubMedCrossRefGoogle Scholar
  29. 29.
    Shapiro RL (2005) Ndung’u T, Lockman S et al. Highly active antiretroviral therapy started during pregnancy or postpartum suppresses HIV-1 RNA, but not DNA, in breast milk. J Infect Dis 192:713–719PubMedCrossRefGoogle Scholar
  30. 30.
    Lehman DA, Chung MH, John-Stewart GC et al (2008) HIV-1 persists in breast milk cells despite antiretroviral treatment to prevent mother-to-child transmission. AIDS 22:1475–1485PubMedCrossRefGoogle Scholar
  31. 31.
    Kilewo C, Karlsson K, Massawe A et al (2008) Prevention of mother-to-child transmission of HIV-1 through breast-feeding by treating infants prophylactically with lamivudine in Dar es Salaam, Tanzania: the Mitra Study. J Acquir Immune Defic Syndr 48:315–323PubMedCrossRefGoogle Scholar
  32. 32.
    Bulterys M, Fowler MG, Van Rompay KK, Kourtis AP (2004) Prevention of mother-to-child transmission of HIV-1 through breast-feeding: past, present, and future. J Infect Dis 189:2149–2153PubMedCrossRefGoogle Scholar
  33. 33.
    Palumbo P, Lindsey JC, Hughes MD et al (2010) Antiretroviral treatment failure for children with peripartum nevirapine exposure. N Engl J Med 363:1510–1520PubMedCrossRefGoogle Scholar
  34. 34.
    Moorthy A, Gupta A, Bhosale R et al (2009) Nevirapine resistance and breast-milk HIV transmission: effects of single and extended-dose nevirapine prophylaxis in subtype C HIV-infected infants. PLoS One 4:e4096PubMedCrossRefGoogle Scholar
  35. 35.
    ClinicalTrials.gov (2010) Comparison of efficacy and safety of infant peri-exposure prophylaxis with lopinavir/ritonavir versus lamivudine to prevent HIV-1 transmission by breastfeeding. http://clinicaltrials.gov/ct2/show/NCT00640263. Updated 8 Apr 2010. Accessed 10 Jan 2011
  36. 36.
    World Health Organization (2010) Antiretroviral therapy for HIV infection in adults and adolescents. Recommendations for a public health approach. 2010 Revision. www.who.int. Accessed 10 Nov 2010.
  37. 37.
    Peltier CA, Ndayisaba GF, Lepage P et al (2009) Breastfeeding with maternal antiretroviral therapy or formula feeding to prevent HIV postnatal mother-to-child transmission in Rwanda. AIDS 23:2415–2423PubMedCrossRefGoogle Scholar
  38. 38.
    Zeh C, Weidle P, Nafisa L, Musuluma H, Okonji J, Anyango E (2008) Emergence of HIV-1 drug resistance among breastfeeding infants born to HIV-infected mothers taking antiretrovirals for prevention of mother-to-child transmission of HIV: The Kisumu Breastfeeding Study, Kenya. In: 15th Conference on retroviruses and opportunistic infections. http://www.retroconference.org/AbstractSearch/Default.aspx?Conf=19. Accessed 20 Apr 2010
  39. 39.
    Mirochnick M, Thomas T, Capparelli E et al (2009) Antiretroviral concentrations in breast-feeding infants of mothers receiving highly active antiretroviral therapy. Antimicrob Agents Chemother 53:1170–1176PubMedCrossRefGoogle Scholar
  40. 40.
    ClinicalTrials.gov (2010) Evaluating strategies to reduce mother-to-child transmission of HIV infection in resource-limited countries (PROMISE). http://clinicaltrials.gov/ct2/show/NCT01061151. Updated 14 Apr 2010. Accessed 30 Apr 2010
  41. 41.
    ClinicalTrials.gov (2009) Universal use of EFV-TDF-FTC and AZT-3TC-LPV/r combinations for HIV-1 PMTCT in pregnant and breastfeeding women: a phase 3 trial (UMA). http://clinicaltrials.gov/ct2/show/NCT00936195?term=UMA%26rank=1. Updated 6 Aug 2009. Accessed 20 Jan 2011
  42. 42.
    World Health Organization (2010) Guidelines on HIV and infant feeding. Principles and recommendations for infant feeding in the context of HIV and a summary of evidence. www.who.int. Accessed 10 Nov 2010
  43. 43.
    Kuhn L, Aldrovandi MG, Sinkala M et al (2010) Potential impact of new World Health Organization criteria for antiretroviral treatment for prevention of mother to child HIV transmission. AIDS 24:1374–1377PubMedCrossRefGoogle Scholar
  44. 44.
    Thior I, Lockman S, Smeaton LM et al (2006) Breastfeeding plus infant zidovudine prophylaxis for 6 months vs formula feeding plus infant zidovudine for 1 month to reduce mother-to-child HIV transmission in Botswana: a randomized trial: the Mashi Study. JAMA 296:794–805PubMedCrossRefGoogle Scholar
  45. 45.
    Bulterys M, Ellington S, Kourtis AP (2010) HIV-1 and breastfeeding: biology of transmission and advances in prevention. Clin Perinatol 37:807–824PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Athena P. Kourtis
    • 1
  • Isabelle de Vincenzi
    • 2
  • Denise J. Jamieson
    • 1
  • Marc Bulterys
    • 3
    • 4
    • 5
  1. 1.Division of Reproductive HealthNCCDPHP, Centers for Disease Control and PreventionAtlantaUSA
  2. 2.World Health OrganizationGenevaSwitzerland
  3. 3.Division of Global HIV/AIDS (DGHA)Center for Global Health, Centers for Disease Control and Prevention (CDC)AtlantaUSA
  4. 4.CDC Global AIDS ProgramBeijingChina
  5. 5.UCLA School of Public HealthLos AngelesUSA

Personalised recommendations