Prevention regimens in Africa need to deter women from breastfeeding.(Brief Article)

2002 JUN 27 - (NewsRx.com & NewsRx.net) -- by Michael Greer, senior medical writer - Treatment to prevent mother-to-child transmission of HIV in developing countries needs to be accompanied by ways to deter women from breastfeeding, researchers in Europe say.

"Large reductions in transmission of HIV-1 from mother to child have been achieved in more-developed countries due to the use of antiretrovirals," explained Dr. Joep M. A. Lange and colleagues at the University of Amsterdam's Academic Medical Center in Amsterdam, Georg-Speyer-Haus Institute for Biomedical Research in Frankfurt, Germany, and the Swedish Institute for Infectious Disease Control and the Karolinska Institute in Stockholm, Sweden. "Short-course regimens, suitable for resource-poor countries, have also been shown to significantly reduce peripartum HIV-1 transmission."

However, mothers targeted by these regimens often continue to breastfeed their children, increasing the risk of vertical HIV transmission, Lange and coauthors found.

The researchers evaluated the effectiveness of short-course regimens using zidovudine and lamivudine in South Africa, Uganda, and Tanzania, all areas where breastfeeding is common. Almost 1800 HIV[superscript]+ mothers were randomized to one of three antiretroviral regimens or to a placebo, according to the report.

Women who received zidovudine and lamivudine from the 36th week of gestation until after delivery, and whose infants were also treated with these antiretrovirals shortly after birth, had their vertical transmission risk reduced by more than 60%. However, the postpartum transmission rate jumped from less than 6% for treated women 6 weeks after delivery to 15% after 18 months, ...