WEDNESDAY, June 4 (HealthDay News) -- Each year, an estimated
200,000 babies worldwide are infected with the AIDS virus through
their mother's breast milk. Now, a new study suggests that a
short-term drug regimen could provide significant protection for
infants.
"It is very practical, and these drugs are relatively cheap. We
believe a large proportion [of infants] can be protected," said
study co-author Dr. Taha E. Taha, co-director of the infectious
disease program at Johns Hopkins University's Bloomberg School of
Public Health.
The problem of HIV transmission through breast milk is
especially acute in sub-Saharan Africa, where mothers rarely use
formula, Taha said, while it's not a significant problem in the
United States.
The estimated 200,000 infants worldwide who get AIDS annually
through breast milk make up a huge portion of the 500,000 new
infections. (Babies can also get HIV about 10 percent of the time
during gestation when a mother is infected, Taha said.)
One solution would be to discourage breast-feeding, but a number
of challenges would make it difficult to replace breast-feeding
with formula in parts of Africa, Taha said. Among other hurdles,
the lack of clean water would make it impossible to sanitize
bottles used for formula, he said.
Assuming that breast-feeding is unlikely to decline, Taha and
his colleagues tested three drug regimens designed to prevent HIV
transmission through breast milk. They tested the regimens on 3,016
infants in the African country of Malawi.
One regimen, known as the control group, included a single dose
of the AIDS drug nevirapine (Viramune) plus one week of treatment
with the drug zidovudine (AZT or Retrovir). The other regimens
added daily doses of nevirapine or nevirapine as well as zidovudine
until the age of 14 weeks.
The infants who took the control-group regimen had the highest
rates of HIV infection from the age of 6 weeks to 18 months. At
nine months, 11 percent of the control group infants were infected
with the virus, compared to 5.2 and 6.4 percent, respectively,
among the nevirapine and the nevirapine-plus-zidovudine groups.
The findings were published online Wednesday in the
New England Journal of Medicine and were expected to be in
the July 10 print issue of the journal.
Another study in the same issue of the journal found that
stopping breast-feeding early and abruptly -- as early as four
months after birth -- doesn't significantly lower the risk that
infants will become infected with HIV.
About two-thirds of a group of infants in the African nation of
Zambia whose mothers stopped breast-feeding before five months
lived without developing HIV infection to the age of 24 moths. In
another group, in which mothers breast-fed for an average of 16
months, about the same percentage lived for 24 months without
becoming infected with HIV.
In a commentary accompanying the two studies, a pair of AIDS
specialists in South Africa praised the research. But they wrote
that more studies need to look at whether HIV transmission can be
prevented by both extending drug treatment and shortening the time
of breast-feeding.
Still, the findings of the second study suggest that "one should
not stop breast-feeding in infants whose HIV status you don't know.
Stopping breast-feeding in HIV-infected infants was harmful," said
Glenda Gray, one of the commentary authors and director of the
Perinatal HIV Research Unit at the University of Witwatersrand in
Johannesburg.
More information
Learn more about breast-feeding and HIV from
avert.org.