More children of HIV positive mothers saved
Infants who are breastfed by HIV positive mothers are not infected by HIV if they are treated with certain medicines, according to new research at the University of Bergen with partners.
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An estimated 420,000 children are infected with HIV every year, and about half of these children are infected via HIV positive mothers. This occurs almost exclusively in low-income countries. So far, this type of infection of children has been considered an unsolved problem.
鈥淚f no measures are in place, between 30 and 45 per cent of children of HIV positive mothers in Africa will contract the HIV virus,鈥� says Professor Thorkild Tyllesk盲r at the Centre for International Health at the University of Bergen (幸运飞艇计划). Tyllesk盲r is a specialist in maternal and child health and has worked on HIV-preventive measures in low-income countries for a number of years.
鈥淗alf of the children are infected late in the pregnancy or during labour,鈥� says Tyllesk盲r. 鈥淭he other half is infected during breastfeeding.鈥�
Remarkable results
Due to the study PROMISE PEP: Prevention of mother to child transmission of HIV, which took place in the five year-period 2008鈥�2013, 聽the researchers have found a solution. Professor Tyllesk盲r is one of researchers responsible for the study, and on 5 March 2014 he presented the results from the study at the (CROI) in Boston in the United States.
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鈥淎nti-retroviral drugs are the most common when treating or preventing HIV infection,鈥� Tyllesk盲r explains. 鈥淎fter all, HIV is a so-called retrovirus. Hence the name. There are around 20 medications in use for treating HIV infection, and most patients receive a cocktail of several drugs.鈥�
Research shows that infants who are breastfed by HIV positive mothers, are not infected if they are taking certain medications. The study led by Tyllesk盲r and others shows that if two specific different medicines are given, both prevent the child from HIV infection.
The two medicines used in the study are lopinavir/ritonavir (LPV/r) and lamivudine (3TC). A randomised, controlled trial was conducted, where the effect of these two drugs was compared. Children received medication twice daily from seven days of age and until breastfeeding ended, alternatively until week 50.
Challenges in poor countries
For the past 15 years, doctors have understood that infection is preventable if the mother receives anti-retroviral drugs during pregnancy and birth. In Scandinavia this has been implemented into the healthcare system, but in countries with a less developed system it is still a challenge in getting mothers to take their medication on a regular basis.
鈥淩esearchers have disagreed about how to act during the breastfeeding period. In Scandinavia we have not allowed the mother to breastfeed the child, and this has worked well,鈥� Tyllesk盲r says. 鈥淚n Africa, the same method has been applied, but this caused only problems. In 2006 in Botswana there was a terrible epidemic of gastroenteritis among non-breastfed infants, with over 50,000 hospital admissions and where 600 infants died.鈥�
Children infected by mothers
In the study researchers examined 1,273 children who were breastfed by HIV-infected mothers. Only 1.5 per cent of the children contracted HIV in their first year of life. This is considered a good result. The study was conducted in Burkina Faso, Uganda, Zambia and South Africa.
鈥淎s long as we do not control the HIV epidemic among adults, drugs like this can be very useful,鈥� says Tyllesk盲r. 鈥淚t is difficult to find appropriate medications for such treatment and that avoid side effects that may harm the child.鈥�
The study was funded by the (ANRS), the (EDCTP) and the .
