Study finds HIV breastfeeding risk highest in early months a...( ted HIV infections. Positive HIV tests...),Health

Subsequent HIV tests conducted over the next two years revealed that 47 of the 672 infants in the study became HIV-infected from breastfeeding. Nearly half (21) of the infections occurred within five months after birth. Another 15 babies became infected between postnatal months 6 and 11, and seven more between months 12 and 17 of follow-up. Only four HIV infections occurred between months 18 and 23. No babies became infected with HIV after they stopped breastfeeding.

Statistical analyses showed that women who had fewer than four previous births were more likely to transmit HIV through breast milk than were women who had four or more. Similarly, younger mothers were more likely than older mothers to transmit HIV through breast milk.

Drs. Miotti, Biggar and their colleagues speculate that mothers who are relatively less experienced with breastfeeding are more likely to have subclinical mastitis, an inflammation of the mammary tissue, and thereby a higher HIV transmission rate. The researchers note that in another recent study conducted among a separate population of women in Malawi, they found that subclinical mastitis was associated with higher HIV levels in breast milk and higher HIV transmission to breastfeeding infants.

"HIV transmission was highest in the early months, but persisted for as long as infants continued breastfeeding," notes Dr. Miotti. "Early weaning has been proposed as one possible strategy to limit HIV transmission through breast milk," he adds. "Although discontinuing breastfeeding after six months would have prevented half of the HIV infections seen in our study, such an approach would increase the risk for illness and death from the respiratory and diarrheal diseases that antibodies and other factors in breast milk help protect against."

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Contact: John Bowersox
jbowersox@nih.gov
301-402-1663
NIH/National Institute of Allergy and Infectious Diseases
24-Aug-1999