Preexposure HIV Prophylaxis During Breast-Feeding

When given to infants of HIV-positive women, lamivudine or lopinavir-ritonavir reduced HIV acquisition.

Efforts to reduce HIV transmission to infants during breast-feeding include maternal antiretroviral therapy (ART) and infant preexposure prophylaxis (PrEP). Most studies have used nevirapine for ≤6 months — however, some women breast-feed for at least 1 year. To assess the efficacy of daily lopinavir-ritonavir compared with lamivudine, investigators randomized 1273 HIV-negative infants in Burkina Faso, Zambia, South Africa, and Uganda who were born to HIV-positive women ineligible for ART (median CD4 count, 529 cells/µL). Drugs were provided in liquid form and administered twice daily until 1 week after weaning or postnatal week 50. All mothers and neonates had received routine HIV transmission prophylaxis (maternal zidovudine during pregna…

Reviewing Author

Anna Wald, MD, MPH

Disclosures

Consultant/Advisory BoardAicuris; Bayer; GSK; Innovative Molecules; Merck; MAPP Biopharmaceutical (Safety Monitoring Committee)

RoyaltiesUpToDate

Grant/Research SupportNIH/National Institute of Allergy and Infectious Diseases; GSK; Moderna; Assembly Biomedical; Aicuris

Editorial BoardsSexually Transmitted Diseases; Sexually Transmitted Infections; Journal of Infectious Diseases

Leadership PositionsID Division Chiefs Community of Practice (At-Large Member)