Antiretroviral Strategies for Preventing Breast Milk Transmission of HIV

Significant gains have been made in preventing transmission from mother to child by the use of abbreviated regimens of antiretroviral therapy initiated antenatally, intrapartum and in the early postnatal period. However, there are limited strategies for preventing breast milk transmission, and previous attempts to minimize breast milk transmission have concentrated on the duration and pattern of breastfeeding. The use of antiretroviral prophylaxis either for HIV-exposed breastfed infant or for HIV-infected mother during the breastfeeding period has the potential to drive transmission rates further in settings where breastfeeding is essential to infant survival. This article examines recently published studies that evaluate antiretroviral strategies to prevent and assess their role in the transmission of HIV through breast milk.