Does U=U for breastfeeding mothers and infants? Breastfeeding by mothers on effective treatment for HIV infection in high-income settings



Waitt, CJ ORCID: 0000-0003-0134-5855, Lowe, Nicola, van de Perre, Philippe, Lyon, Fiona, Loutfy, Mona and Aebi-Popp, Karoline
(2018) Does U=U for breastfeeding mothers and infants? Breastfeeding by mothers on effective treatment for HIV infection in high-income settings. The Lancet HIV, 5 (9). E531-E536.

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Abstract

Can the campaign phrase, undetectable=untransmissible (U=U), established for the sexual transmission of HIV, be applied to the transmission of HIV through breastfeeding? European AIDS Clinical Society and, to some extent American guidelines, now state that HIV-infected mothers who wish to breastfeed should be supported, with ‘increased clinical and virological monitoring’. This paper summarises existing evidence about transmission of HIV through breastfeeding, differences in HIV dynamics and viral load between breastmilk and plasma, and the effects of antiretrovirals on infants. At present, there is insufficient evidence for clear recommendations about the frequency of clinical and virological monitoring required for mother and infant in a breastfeeding relationship or about the action to be taken in the event of viral rebound. We propose a roadmap for collaborative research to provide the missing evidence required to enable mothers who wish to breastfeed to make a fully informed choice.

Item Type: Article
Uncontrolled Keywords: Milk, Human, Humans, HIV Infections, Anti-HIV Agents, Drug Monitoring, Viral Load, Breast Feeding, Developed Countries, Infant, Practice Guidelines as Topic, Infectious Disease Transmission, Vertical
Depositing User: Symplectic Admin
Date Deposited: 29 Jun 2018 08:17
Last Modified: 19 Jan 2023 01:31
DOI: 10.1016/S2352-3018(18)30098-5
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3023147