Antiretroviral therapy among HIV-infected breastfeeding mothers: a promising strategy to prevent HIV transmission through breastmilk in Africa
Résumé
Evaluation of: Giuliano M et al. 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(3), 286-291 (2007). Maternal highly active antiretroviral therapy (HAART) starting during the late prenatal period and prolonged during lactation is a potentially interesting strategy to prevent mother-to-child transmission of HIV through breastfeeding in Africa. In this report, Giuliano et al. showed that HIV-infected women treated with HAART from before delivery had lower cell-free HIV RNA load in breastmilk, and were less likely to have a detectable viral load in this compartment one week after delivery, when compared to untreated women. Antiretroviral therapy among HIV-infected breastfeeding mothers could thus be a promising strategy to prevent HIV transmission through breastmilk in Africa if further larger studies confirm its safety. This strategy could also provide a link between prevention and care, since maternal HAART provided in pregnancy and during the breastfeeding period can be thereafter continued among women who meet the criteria for their own health.
Domaines
Santé publique et épidémiologie
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