New Study On HIV Transmission and Breastfeeding Should Inform US Global Health Policy

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The link between HIV/AIDS and child and maternal health just got more inextricable.

According to a study of HIV-positive mothers and babies in Zambia, published this week in Clinical Infectious Diseases, early weaning of uninfected infants more than doubled the risk of death among those children. The study suggests, in other words, that antiretroviral therapy for mothers, allowing them to breastfeed for long periods of time, can save the lives of their uninfected children.

The article sheds new light on a deadly catch-22 that HIV-positive women in resource-poor countries have long faced: risk passing the HIV virus to a baby through extended breastfeeding, or risk increased mortality from other childhood illnesses by truncating breastfeeding.

The findings come as the Obama Administration considers a possible shift in global health priorities, with some White House officials advocating increased resources for fighting childhood diarrhea and other maternal and child health issues instead of continued scale-up of HIV/AIDS treatment.

This new CID article helps demonstrate just how false that choice is. In the Zambia study, the authors report that leading cause of death for uninfected children weaned between 6 and 24 months was diarrhea. Meanwhile, they write: “Our data …demonstrate that the survival of uninfected children born to HIV-infected mothers is compromised through the second year of life if breast-feeding is stopped early.”

One can only conclude that the goals of fighting AIDS and childhood diarrhea should not be pitted against each other; more widespread access to antiretroviral therapy for pregnant and nursing mothers will not only save the lives of those mothers, but may also reduce the chances that their babies die from diarrhea.

“As these interventions scale up, this study reminds us that MTCT and mortality are inextricably bound and must be addressed as a whole,” Drs. Robert Shapiro and Shanin Lockman write in an accompanying CID commentary.

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