BACKGROUND: The ability of highly active antiretroviral therapy (HAART) to reduce human immunodeficiency virus type 1 (HIV-1) RNA and DNA in breast milk has not been described. METHODS: We compared breast-milk HIV-1 RNA and DNA loads of women in Botswana who received HAART (nevirapine, lamivudine, and zidovudine) and women who did not receive HAART. RESULTS: Women in the HAART group received treatment for a median of 98 days (range, 67-222 days) at the time of breast-milk sampling; 23 (88%) of 26 had whole breast-milk HIV-1 RNA loads <50 copies/mL, compared with 9 (36%) of 25 women who did not receive HAART (P=.0001). This finding remained significant in a multivariate logistic-regression model (P = .0006). The whole-milk HIV-1 DNA load was unaffected by HAART. Of women who received HAART, 13 (50%) of 26 had HIV-1 DNA loads <10 copies/10(6) cells, compared with 15 (65%) of 23 who did not receive HAART (P = .39). CONCLUSIONS:HAART suppressed cell-free HIV-1 RNA in breast milk and may therefore reduce mother-to-child transmission (MTCT) of HIV-1 via breast-feeding. However, HAART initiated during pregnancy or early after delivery had no apparent effect on cell-associated HIV-1 DNA loads in breast milk. Clinical trials to determine MTCT among breast-feeding women receiving HAART are needed.
RCT Entities:
BACKGROUND: The ability of highly active antiretroviral therapy (HAART) to reduce human immunodeficiency virus type 1 (HIV-1) RNA and DNA in breast milk has not been described. METHODS: We compared breast-milk HIV-1 RNA and DNA loads of women in Botswana who received HAART (nevirapine, lamivudine, and zidovudine) and women who did not receive HAART. RESULTS:Women in the HAART group received treatment for a median of 98 days (range, 67-222 days) at the time of breast-milk sampling; 23 (88%) of 26 had whole breast-milk HIV-1 RNA loads <50 copies/mL, compared with 9 (36%) of 25 women who did not receive HAART (P=.0001). This finding remained significant in a multivariate logistic-regression model (P = .0006). The whole-milk HIV-1 DNA load was unaffected by HAART. Of women who received HAART, 13 (50%) of 26 had HIV-1 DNA loads <10 copies/10(6) cells, compared with 15 (65%) of 23 who did not receive HAART (P = .39). CONCLUSIONS: HAART suppressed cell-free HIV-1 RNA in breast milk and may therefore reduce mother-to-child transmission (MTCT) of HIV-1 via breast-feeding. However, HAART initiated during pregnancy or early after delivery had no apparent effect on cell-associated HIV-1 DNA loads in breast milk. Clinical trials to determine MTCT among breast-feeding women receiving HAART are needed.
Authors: Michael H Chung; James N Kiarie; Barbra A Richardson; Dara A Lehman; Julie Overbaugh; Francis Njiri; Grace C John-Stewart Journal: J Acquir Immune Defic Syndr Date: 2007-12-01 Impact factor: 3.731
Authors: Dara A Lehman; Michael H Chung; Grace C John-Stewart; Barbra A Richardson; James Kiarie; John Kinuthia; Julie Overbaugh Journal: AIDS Date: 2008-07-31 Impact factor: 4.177
Authors: Cécile Alexandra Peltier; Gilles François Ndayisaba; Philippe Lepage; Johan van Griensven; Valériane Leroy; Christine Omes Pharm; Patrick Cyaga Ndimubanzi; Olivier Courteille; Vic Arendt Journal: AIDS Date: 2009-11-27 Impact factor: 4.177
Authors: B Lohman-Payne; J A Slyker; B A Richardson; C Farquhar; M Majiwa; E Maleche-Obimbo; D Mbori-Ngacha; J Overbaugh; S Rowland-Jones; G John-Stewart Journal: Clin Exp Immunol Date: 2009-06 Impact factor: 4.330
Authors: Michael H Chung; James N Kiarie; Barbra A Richardson; Dara A Lehman; Julie Overbaugh; John Kinuthia; Francis Njiri; Grace C John-Stewart Journal: Antivir Ther Date: 2008