Mother to child breast feeding effect when antiretroviral drug is involved

Emobileclinic Researchers Corner



In a recent publication by the PLOS Medicine, researchers from University of Washington have revealed that there is a low risk of side effects in breastfed infants exposed to antiretroviral drugs.


There has been growing concern on whether a breast feeding mother who is HIV positive should feed her baby with breast milk or not. The antiretroviral drugs tenofovir and emtricitabine used by breastfeeding mother with HIV positive status seem to be present at low concentrations in breast milk and in the bloodstream of their infants.

Pre-exposure prophylaxis (PrEP) uses antiretroviral drugs to avert HIV infection and is generally recommended for people with increase risk of being infected with HIV. It must be stated emphatically that no specific scientific evidence is available to support the safety of PrEP in women who are breastfeeding.
The researchers focused and analyzed 50 pairs of mothers and infants in Kenya and Uganda who were free of HIV for 6 months after birth. The mothers were given the combination of oral PrEP drug emtricitabine (tenofovir disoproxil fumarate) for 10 days and drug concentrations were measured in breast milk and infant blood.

Although, a small group of women and infants participated in the research, the timing of the study was also short and limited to a single blood draw from infants. Notwithstanding these issues, the findings reveal that drug concentrations are low in breast milk and in infants’ blood and that the risk of adverse events is therefore likely to be small.

While discussing the research findings, Lynne Mofenson and Elizabeth Glaser of Pediatric AIDS Foundation, Washington, D.C., were of the opinion that there is need to extend implementation of PrEP with tenofovir to pregnant and breastfeeding women who have high risk of HIV infection.
This research was supported by the Bill and Melinda Gates Foundation as well as the US National Institutes of Health.

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Ngure K, (2016): Pre-exposure Prophylaxis Use by Breastfeeding HIV-Uninfected Women: A Prospective Short-Term Study of Antiretroviral Excretion in Breast Milk and Infant Absorption. PLOS Medicine, doi:10.1371/journal.pmed.1002132

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