Triple antiretroviral prophylaxis administered during pregnancy and after delivery significantly reduces breast milk viral load: A study within the drug resource enhancement against AIDS and malnutrition program

Marina Giuliano, Giovanni Guidotti, Mauro Andreotti, Maria F. Pirillo, Paola Villani, Giuseppe Liotta, Maria Cristina Marazzi, Maria Grazia Mancini, Maria Cusato, Paola Germano, Sandra Loureiro, Susanna Ceffa, Mario Regazzi, Stefano Vella, Leonardo Palombi

Research output: Contribution to journalArticle

Abstract

BACKGROUND: The administration of antiretroviral therapy to lactating women could represent a possible strategy to reduce postnatal HIV transmission. In this study, we assessed the effect of antiretroviral treatment on breast milk viral load and determined plasma and breast milk drug concentrations in pregnant women receiving highly active antiretroviral therapy (HAART). METHODS: We studied 40 women receiving zidovudine, lamivudine, and nevirapine from 28 weeks of gestation to 1 month postpartum (group A) and 40 untreated pregnant women (group B). Blood and breast milk samples were collected at delivery and 7 days postpartum. RESULTS: Women in group A had received a median of 85 days of therapy before delivery. Median breast milk concentrations of nevirapine, lamivudine, and zidovudine were 0.6, 1.8, and 1.1 times, respectively, those in maternal plasma. HIV RNA levels in breast milk were significantly lower in group A than in group B (median of 2.3 vs. 3.4 log at delivery and 1.9 vs. 3.6 log at day 7; P <0.001 for both comparisons). CONCLUSIONS: Antiretroviral drugs administered during the last trimester of pregnancy and after delivery reach levels similar to or higher than plasma concentrations in breast milk and can significantly reduce HIV RNA levels. Our data support the potential role of maternal HAART prophylaxis in reducing the risk of breast-feeding-associated transmission.

Original languageEnglish
Pages (from-to)286-291
Number of pages6
JournalJournal of Acquired Immune Deficiency Syndromes
Volume44
Issue number3
DOIs
Publication statusPublished - Mar 2007

Keywords

  • Antiretroviral therapy
  • Breast-feeding
  • Mother-to-child transmission
  • Mozambique

ASJC Scopus subject areas

  • Virology
  • Immunology

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    Giuliano, M., Guidotti, G., Andreotti, M., Pirillo, M. F., Villani, P., Liotta, G., Marazzi, M. C., Mancini, M. G., Cusato, M., Germano, P., Loureiro, S., Ceffa, S., Regazzi, M., Vella, S., & Palombi, L. (2007). Triple antiretroviral prophylaxis administered during pregnancy and after delivery significantly reduces breast milk viral load: A study within the drug resource enhancement against AIDS and malnutrition program. Journal of Acquired Immune Deficiency Syndromes, 44(3), 286-291. https://doi.org/10.1097/QAI.0b013e31802c5441