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Uganda: Breastfeeding Lowers HIV Transmission - Study

<p>Taddeo Bwambale</p>


May 5, 2013

Mothers living with HIV, who breastfeed exclusively for longer than the first four months, lower the risk of transmitting the virus to their babies.

A study published, recently, in the Science Translational Medicine shows that mothers who stop breastfeeding abruptly have higher levels of HIV than those who continue breastfeeding.

The research dispels the argument that weaning children from breast milk early, lowers risks of passing on HIV.

The study examined the prevalence of the HIV-1 strain among 958 women and their infants in Lusaka, Zambia, over a 24-month period.

The women were randomly asked to wean abruptly at four months, or to continue breastfeeding for a duration of their choice.

After six weeks, researchers discovered a higher viral load in breast milk of mothers, who had stopped breastfeeding, compared to those who chose to continue breastfeeding.

The study also found that those who breastfed their infants exclusively had a significantly lower viral load, compared to those who also fed their babies on other foods.

"Higher milk viral concentrations after stopping breastfeeding were found to be higher than expected rates of late postnatal HIV transmission in those who weaned early," the study says.

The study suggests frequency of breastfeeding influenced the level of HIV in breast milk.

The study encourages the continuation of antiretroviral treatment for mothers even after weaning their children from breast milk.

Option B Plus

Last year, the Government adopted a model dubbed Option B Plus, in which all HIVpositive pregnant women are enrolled on anti-retroviral (ARV) drugs, irrespective of their CD4 count.

However, Dr. Alex Coutinho, one of the pioneer HIV/AIDS specialists and head of the infectious disease institute (IDI), says Option B Plus makes breastfeeding safer by reducing the viral load to an uninfective level.

Before 2006, the World Health Organisation recommended that only women with a low CD4 count should receive ARVs. The guidelines encouraged HIV-positive mothers to exclusively breastfeed for six months and then rapidly wean to avoid transmitting HIV to their infant.

Dr. Apuuli Kihumuro, the director-general of the Uganda AIDS Commission, adds:

"The study is overtaken by events. When we adopted the Option B Plus, our target was to ensure that all breastfeeding mothers were enrolled on treatment."

"As long as all pregnant mothers are tested for HIV and those who are infected get started on treatment right away, the chances of transmitting the disease are significantly reduced."

Under the Option B Plus, however, both the breastfeeding mother and the baby are given ARVs to prevent the possibility of infection.

Dr. Lydia Mungherera, a member of Uganda's Option B Plus taskforce, declined to comment on the study.

She, however, notes that the best way to reduce chances of mother-to-child transmission was by ensuring that all expectant mothers who test HIV-positive are put on ARVs. Mungherera also observed the need to address the underlying issues affecting HIV-positive mothers, such as stigma, disclosure and treatment care.

1.5 million pregnancies

Every year, at least 1.5 million women living with HIV become pregnant globally, according to the World Health Organisation.

Studies show that without taking ARVs, babies stand a 15% to 45% chance of contracting HIV if their mothers are infected, but taking ARVs reduces transmission to below 5%.



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