The largest study to date to examine methods to prevent HIV infection among breastfeeding infants concludes that giving antiretroviral drugs to HIV-infected breastfeeding mothers in sub-Saharan Africa or giving an HIV-fighting syrup to their babies are both effective.
"Our study found that both methods are effective in preventing HIV transmission, but given a choice between the two, I'd say that the baby regimen is the more successful method," said Charles Chasela, PhD, coordinator and lead author of the study, which was published in the June 17, 2010 issue of the New England Journal of Medicine.
"The antiretroviral regimen for treating the mothers is much more expensive and requires access to medical facilities that aren't widely available in developing countries such as Malawi, where our study was conducted," added Charles van der Horst, MD, a professor of infectious diseases in the UNC School of Medicine and senior author of the study. "The baby regimen, in comparison, is incredibly cheap and much easier to implement."
These findings are important, van der Horst said, because each year about 200,000 infants worldwide become infected with HIV through breastfeeding, and in the developing world infant formula is both prohibitively expensive and associated with increased infant deaths.
In the study, called the Breastfeeding, Antiretrovirals and Nutrition Study (BAN), 2,369 breastfeeding mother-infant pairs in Lilongwe, Malawi, were randomly assigned to one of three groups: a maternal antiretroviral therapy (ART) group, a second group in which infants were treated with nevirapine liquid and a control group for whom medications were given at the time of delivery only. None of these women had developed AIDS yet and thus did not need treatment for their own health.
After their babies were born, women in the maternal antiretroviral group received a single tablet twice a day containing the drugs zidovudine and lamivudine. They also received a dose of nevirapine by mouth once a day for 14 days and then twice daily from 2 to 28 weeks.