Antiviral Cocktail Cuts|HIV Risk to Newborns

     (CN) – A cocktail of antiviral medication can prevent HIV-positive mothers from passing the disease onto their newborns while breastfeeding, researchers say.
The findings from the ongoing Promoting Maternal and Infant Survival Everywhere (PROMISE) study funded by the National Institutes of Health bodes well for otherwise healthy and symptomatic HIV-infected women in developing countries.
     By taking a trio of antiretroviral drugs throughout pregnancy, childbirth and infancy, they can now “essentially eliminate” the risk of contaminating their breast milk with the disease, the NIH announced Monday.
     Researchers with International Maternal Pediatric Adolescent AIDS Clinical Trials network have been studying the effect of antiretroviral therapy for the past three years on over 2,000 mothers and babies in India and several sub-Saharan nations.
     Among the similarities the selected nations share is they all are plagued by widespread water pollution, which makes the just-add-water component of formula feeding dangerous to infant health.
     So far, the researchers say, the results are promising, with mortality rates falling to almost nil among breastfed newborns a steep drop from the estimated 15-45 percent rate of HIV infection passed down from mother to child during various stages of pregnancy, labor and breastfeeding without the drugs, according to World Health Organization.
     “Infant mortality can be high in resource-limited countries, but in this study, nearly 99 percent of babies lived to see their first birthday,” the NIH said in a written statement.
     The findings are also in line with a 2015 WHO recommendation of lifelong courses of antiretroviral therapy for all HIV-positive expectant mothers.
     The federal medical research agency funded the study in 2011 through PROMISE, an arm of its child health and infectious disease chapters.
     “These findings add to the considerable body of evidence confirming the benefits of antiretroviral therapy for every person living with HIV,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, in a statement.
     “Maternal antiretroviral therapy safely minimizes the threat of HIV transmission through breast milk while preserving the advantages of breastfeeding, as the high infant survival in this study underscores,” Fauci said.
     Along with the three-drug regimen administered to their mothers, infants were given the HIV suppressant medication Nevirapine, but the length of their treatment differed slightly.
     Study participants were divided into two different control groups, with infants in the first group getting their medication for only six weeks after birth, and the second group being medicated until their mothers stopped breastfeeding.
     In both cases, antiretroviral therapy was said to bode equally well for their survival. Mother-to-infant HIV transmission rates among those studied were only 0.3 percent for six-month-olds and 0.6 percent after a year, the NIH said.
     Both mother and child were then observed for as long as the mother continued to breastfeed — an average of 15 months after delivery.
     Study findings were presented for the first time in conjunction with the 21st International AIDS Conference.
     The convention is slated to begin Tuesday in Durban, South Africa, but the results of the conference were revealed during a pre-conference workshop on HIV pediatrics.

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