Haroon Saloojee1, Peter A Cooper. 1. Division of Community Paediatrics, Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa. Haroon.Saloojee@wits.ac.za
Abstract
PURPOSE OF REVIEW: To highlight recent research that has contributed to an improved understanding of, or resulted in, important changes in the approach to feeding HIV-exposed infants. RECENT FINDINGS: The administration of antiretroviral therapy to a HIV-positive pregnant woman and its continued use during breast-feeding significantly reduce postnatal HIV transmission to her child. Similarly, extended antiretroviral prophylaxis to the breast-feeding infant dramatically decreases HIV transmission and promotes HIV-free child survival. Predominant breast-feeding may be as effective as exclusive breast-feeding in reducing HIV transmission risk. The protective role of immune modulators such as interferon-gamma and interleukin-15 in preventing breast milk transmission is being better appreciated. Although infant-feeding counseling is critical to the success of infant survival strategies, it is generally done poorly with few examples of successful consequences other than in research settings. SUMMARY: Breast-feeding of HIV-exposed infants can be made considerably safer in resource-constrained settings through the provision of maternal highly active antiretroviral therapy (HAART), maternal short-course antiretrovirals, and extended infant antiretroviral prophylaxis.
PURPOSE OF REVIEW: To highlight recent research that has contributed to an improved understanding of, or resulted in, important changes in the approach to feeding HIV-exposed infants. RECENT FINDINGS: The administration of antiretroviral therapy to a HIV-positive pregnant woman and its continued use during breast-feeding significantly reduce postnatal HIV transmission to her child. Similarly, extended antiretroviral prophylaxis to the breast-feeding infant dramatically decreases HIV transmission and promotes HIV-freechild survival. Predominant breast-feeding may be as effective as exclusive breast-feeding in reducing HIV transmission risk. The protective role of immune modulators such as interferon-gamma and interleukin-15 in preventing breast milk transmission is being better appreciated. Although infant-feeding counseling is critical to the success of infant survival strategies, it is generally done poorly with few examples of successful consequences other than in research settings. SUMMARY: Breast-feeding of HIV-exposed infants can be made considerably safer in resource-constrained settings through the provision of maternal highly active antiretroviral therapy (HAART), maternal short-course antiretrovirals, and extended infant antiretroviral prophylaxis.
Authors: Ingunn Ms Engebretsen; Karen M Moland; Jolly Nankunda; Charles A Karamagi; Thorkild Tylleskär; James K Tumwine Journal: Int Breastfeed J Date: 2010-10-26 Impact factor: 3.461