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Breast-feeding decreases infant mortality in resource-poor countries, but raises risk for HIV transmission when an HIV-infected mother, her infant, or both are not receiving antiretroviral therapy (ART). In a postpartum substudy of the PROMISE trial (comparing maternal ART [mART] with infant nevirapine [iNVP] for preventing vertical HIV transmission in women who had not received ART during the pregnancy), researchers evaluated the association of maternal viral load (MVL) and CD4 counts with HIV transmission through breast milk. The associations of time-varying MVL and CD4 count with transmission risk were determined using time-to-event analyses by randomized treatment arm.
In all, 2431 mother-infant pairs were enrolled (infant with confirmed…