Breast-feeding moms on drug treatment can relax

CHICAGO: Young breast-feeding African mothers at high risk of getting HIV may breathe a sigh of relief – Pre-exposure Prophylaxis (PrEP) entails minimal drug exposure for their babies.

This is according to a study led by Dr Kenneth Mugwanya of the University of Washington, which was conducted in Kenya and Uganda, enrolling 50 HIV-uninfected mother-infant pairs between one and 24 weeks after birth.

Mugwanya reported on the study this week at the biennial HIV Research for Prevention conference that is under way in Chicago.

PrEP is the use of antiretroviral medication to prevent people from acquiring HIV – particularly people at high risk of getting HIV – the most commonly used combination being tenofovir and emtricitabine.

As PrEP was becoming more widely used in heterosexual relationships, the study – published in medical journal PLOS Medicine – looked into the important consideration of its safety in infants who were breast-fed by women taking PrEP.

Milk

The 10-day study investigated whether the drugs were excreted into breast milk and then absorbed by the nursing infant in clinically significant concentrations when used as PrEP by lactating women.

The treatment was administered to women aged 22-28 directly and daily.

The highest and lowest level samples of maternal blood and breast milk were taken on days seven and 10, and a single infant blood sample on day seven.

In infant blood, tenofovir was unquantifiable in 46 out of 49 samples (94%) but emtricitabine was detectable in 47/49 (96%) and even then, Mugwanya said, the exposure of emtricitabine was very low compared to the doses used for infant HIV treatment, and there were no safety concerns.

He said there were also no serious adverse side effects noted during the study’s follow-up.

Mugwanya added: “The data should be reassuring to young women in sub-Saharan Africa who spend a significant amount of time of their lives at risk of getting HIV or pregnant.

“It’s also encouraging because the women’s attendance rate to get their doses was really high.”