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. 2019 Jun 19;20(1):912.
doi: 10.4102/sajhivmed.v20i1.912. eCollection 2019.

Peripartum HIV infection in very low birth weight infants fed 'raw' mother's own milk

Melantha Coetzee  1   2 , Suzanne D Delport  2   3
Affiliations

Peripartum HIV infection in very low birth weight infants fed 'raw' mother's own milk

Melantha Coetzee et al. South Afr J HIV Med. .

Abstract

Background: HIV-exposed very low birth weight (VLBW) infants (≤ 1500 g) are considered at high risk of peripartum mother-to-child HIV transmission (MTCT). In the past, they received formula to prevent breast milk related HIV transmission. This denied them the benefits of breast milk, thus exposing the infant to the risk of necrotising enterocolitis (NEC). From 2010, 'raw' mother's own milk (rMOM) has been recommended for term infants whose mothers' received antenatal antiretroviral therapy (ART). At the same time, the infant received antiretroviral (ARV) prophylaxis as per the National Prevention of MTCT programme.

Objectives: To determine the cumulative incidence of peripartum HIV infection by 4-6 weeks of age in HIV-exposed VLBW infants, who received rMOM and infant ARV prophylaxis.

Method: A retrospective, observational audit over 3 years at a single institution was undertaken. The study population comprised HIV-exposed VLBW infants who received both nevirapine prophylaxis and rMOM from birth until discharge. A positive HIV-PCR by 4-6 weeks of life was used to confirm maternal to infant HIV transmission.

Results: Of the 80 eligible infants admitted between 2010 and 2013, 63 (79%) were exposed to antenatal ART. Seventy-eight (97.5%) tested HIV-PCR negative at 4-6 weeks. Of the two infants who tested positive, both presented with features of an acute HIV infection. The absence of MTCT in the remaining 78 infants given ARV prophylaxis and rMOM suggests that rMOM is an unlikely source of infection in the two infected infants.

Conclusion: rMOM, in the presence of infant prophylaxis, was a safe feeding option for HIV-exposed VLBW infants. It should be strongly considered for these infants, as rMOM likely provides additional maternal and child benefits.

Keywords: HIV; Mother-to-child transmission; Mother’s own milk; Nevirapine; Peripartum transmission; Prevention of mother-to-child transmission; Raw breast milk; Very low birth weight.

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Conflict of interest statement

The authors declare that they have no financial or personal relationship(s) that may have inappropriately influenced them in writing this article.

Figures

FIGURE 1
FIGURE 1
Flow chart detailing exclusions.
FIGURE 2
FIGURE 2
The safety of ‘raw’ mother’s own milk in human immunodeficiency virus-exposed very low birth weight infants.
FIGURE 3
FIGURE 3
Three scenarios related to cumulative incidence of peripartum human immunodeficiency virus transmission by 4–6 weeks.
See this image and copyright information in PMC

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References

    1. Department of Health South Africa. The 2015 national antenatal sentinel HIV & syphilis survey report [homepage on the Internet]. 2015 [cited 2019 Apr 7]. Available from: http://www.health.gov.za/index.php/shortcodes/2015-03-29-10-42-47/2015-0....
    1. Xiao P, Zhou Y, Chen Y, et al. . Association between maternal HIV infection and low birth weight and prematurity: A meta-analysis of cohort studies. BMC Pregnancy Childbirth. 2015;15:246 10.1186/s12884-015-0684-z - DOI - PMC - PubMed
    1. Goga AE, Dinh TH, Jackson DJ, et al. . Population-level effectiveness of PMTCT Option A on early mother-to-child (MTCT) transmission of HIV in South Africa: Implications for eliminating MTCT. J Glob Health. 2016;6(2):020405. 10.7189/jogh.06.020405 - DOI - PMC - PubMed
    1. Kourtis AP, Bulterys M. Mother-to-child transmission of HIV: Pathogenesis, mechanisms and pathways. Clin Perinatol. 2010;37(4):721–737. 10.1016/j.clp.2010.08.004 - DOI - PubMed
    1. Hoffman RM, Black V, Technau K, et al. . Effects of highly active antiretroviral therapy duration and regime on risk for mother-to-child transmission of HIV in Johannesburg, South Africa. J Acquir Immune Defic Syndr. 2010;54(1):35–41. 10.1097/QAI.0b013e3181cf9979 - DOI - PMC - PubMed

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