Two studies that support breastfeeding by HIV-positive women in developing countries, reveal that an extended anti-HIV regimen can curb babies' infection rates and breastfeeding can improve survival in those babies infected by their mothers.
A clinical study in Malawi followed 3,016 babies of HIV-positive mothers for two years. Breastfed infants who received prolonged preventative treatment had HIV infection rates less than half of those who received standard care.
Newborns whose mothers are HIV-positive were treated with anti HIV drugs during the first 14 weeks of life, to reduce the likelihood they will be infected while breastfeeding.
The current standard is one shot at birth and a week's treatment with another anti-HIV drug.
"In poor countries where sanitation is a problem, exclusive breastfeeding appears to confer the greatest benefits to infant health and survival, even in mothers with HIV" said Duane Alexander, director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, which sponsored two studies appearing in the online version of the New England Journal of Medicine (NEJM).
"Extended treatment with nevirapine greatly reduces the chances that infants will be infected with HIV through breast milk," he added. "The National Institutes of Health is now sponsoring additional studies to determine the most effective treatments to prevent the spread of HIV through breast milk."
In the Malawi study, after nine months, 5.2 percent of infants treated with nevirapine, and 6.4 percent of those treated with the two antiretrovirals over the same period, contracted HIV from their mothers compared to 10.6 percent for those who received the usual short-term preventative care.
A second clinical study also published in NEJM and carried out in Zambia, meanwhile found that breastfeeding appeared to improve survival rates of newborns whose mothers passed HIV on to them.
The studies may offer new insight into difficult choices parents face in developing countries as they decide between breastfeeding and possibly passing HIV through breast milk, and formula feeding which can undercut natural immunity against other diseases.