Extended infant antiretroviral regime may lower HIV risk during breastfeeding

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Washington, June 5 : Extending the regular antiretroviral regimen given to infants born to HIV mothers can significantly lower the risk of IV transmission from the mother to the child during breast-feeding, says a new study.

In many resource-poor countries, infants born to mothers with HIV receive a single dose of nevirapine (NVP) and a one-week dose of zidovudine (ZDV) to prevent transmission of HIV from the mother to her newborn.

The researchers from Johns Hopkins Bloomberg School of Public Health and the University of Malawi College of Medicine followed 3,016 infants born to HIV-positive mothers; both the infants and mothers were followed for 2 years.

All infants received the standard care of a single dose of NVP and a one-week dose of ZDV to prevent HIV infection.

One group received an additional 14-week prophylaxis with NVP, while another received 14-week regimens of both NVP and ZDV.

The findings showed that the children who received the extended regimens had consistently lower rates of HIV infection compared to children who received the standard care.

At 9 months, 5.2 percent of infants receiving extended NVP, and 6.4 percent of infants receiving extended NVP and ZDV contracted HIV, compared to 10.6 percent of infants receiving the standard of care regimen.

The frequency at which the mothers breastfed their children was similar between all three treatment groups.

"We know that breastfeeding in the first 6 months of life is extremely important for the child's health and survival, especially in resource poor countries. However, women with HIV face a difficult choice because they are also putting the child at risk for HIV," said Taha E. Taha, MD, PhD, senior author of the study and professor in the Bloomberg School's Department of Epidemiology.

"Our findings clearly show that extended drug regimens can significantly reduce the risk of HIV transmission from breastfeeding," Taha added.

The study is available online in New England Journal of Medicine and will appear in the June 10 print edition.


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