Breastfeeding, Antiretroviral, and Nutrition study: Giving ART to mothers or ARV prophylaxis to infants during breastfeeding equally effective at reducing HIV transmission

July 2009

The Breastfeeding, Antiretroviral, and Nutrition (BAN) study investigated the efficacy of giving either maternal HAART or daily nevirapine to prevent mother-to-child transmission of HIV during 24 weeks of exclusive breastfeeding and a four-week weaning period. A control arm received short-course therapy plus nutritional supplementation. Both interventions yielded statistically significant reductions in HIV infection rates and increased HIV-free survival. Among infants uninfected at birth, 28-week infection rates were 1.8% in the infant nevirapine arm, 3% in the maternal HAART arm, and 6.4% in the control arm. Rates of infection or death in those arms were 2.9%, 4.7%, and 7.6%, respectively. The study was not powered to compare the efficacy of the two intervention arms but demonstrated that both infant and maternal interventions can be effective for reducing mother-to-child transmission of HIV from breast milk. These findings are similar to those from the previously published Mitra and Mitra plus studies in Tanzania. Both studies showed an approximate 1% transmission risk between six weeks and six months with maternal HAART or infant prophylaxis through six months.

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