Early trial data of two virally suppressed, breast-feeding women with HIV shows that there may be less of a risk of HIV transmission during breastfeeding than previously believed.
breast milk © NorGal - stock.adobe.com
No HIV RNA copies were detected in the breast milk of two virally suppressed women with HIV, according to the results of a recent preliminary study done at the University of Buenos Aires.
The first woman had nine years of spontaneous viral control, and the second woman was on abacavir–lamivudine–dolutegravir and had an undetectable viral load for more than five years. The second mother breastfed her child for 12 months without any HIV transmission.
Although the researchers didn’t detect HIV RNA copies, they did detect 0.08 and 0.74 HIV DNA copies per million cells, respectively, using full-length individual proviral sequencing. It is not uncommon for HIV DNA to be left behind after the elimination of HIV RNA, but the significance is unclear, the researchers write.
A team of researchers led by Ariel Osegueda, M.Sc., from the National Scientific and Technical Research Council at the University of Buenos Aires, studied HIV reservoirs in the breast milk of two women living with HIV to gain an understanding of the HIV viral landscape in breast milk with long term viral suppression.
Results will be published in the next issue of the Annals of Internal Medicine.
This study is significant because of the current guidelines around women with HIV breast feeding. According to the latest data, there is still a small risk (less than 1%) that a woman on antiretroviral therapy (ART) can pass HIV to her baby through breastfeeding.
Forgoing breastfeeding is not always a realistic option, especially in parts of the world where HIV burden is high and resources are low. Formula can be expensive and difficult to obtain, and studies show that infants not breastfed in these settings had an increased risk of malnutrition, infection and even death.
Without ART, the World Health Organization (WHO) estimates there is a 15% to 20% risk of HIV transmission from breast milk.
As of 2023, the World Health Organization recommends that HIV-positive mothers on ART can breast feed their infants starting at 6 months of age. Breastfeeding should continue to at least 12 to 24 months of age.
“This preliminary study shows that evaluating the HIV landscape in breast milk is feasible and lays the groundwork for future studies evaluating paired blood or breast milk samples from a larger number of WLWH with long-term viral suppression who are receiving new-generation ART,” Osegueda and her team conclude. “Such studies would provide
objective and updated evidence to shape future guidelines for these populations.”
The U.S. Department of Health and Human Services currently recommends that HIV-positive mothers on ART and their physicians make decisions about breastfeeding together.
Lenacapavir HIV PrEP: Not an AIDS Vaccine, but Vaccine Adjacent
June 19th 2025Experts and advocates say that twice-a-year HIV PrEP injections have the prevention potential of a vaccine — and that a once-a-year version of lenacapavir would be even better. But will Yeztugo be available to the people who would benefit most from HIV PrEP?
Read More
Trump Budget Axes CDC HIV Prevention, Shifts Care, Experts Warn of Risks
June 10th 2025Although some HIV programs will remain, the proposed cuts in the fiscal year 2026 budget are too severe and will hinder HIV care and research in the United States, according to Carl Schmid, executive director of the HIV+Hepatitis Policy Institute in Washington, D.C.
Read More
Most HIV Patients Trust Their Providers But Don’t Always Feel Heard, Survey Says
May 27th 2025Almost half (48%) of HIV patients sometimes feel unheard by their healthcare providers, which highlights a need for increased disease awareness, according to the early results of a new ViiV Healthcare survey.
Read More