In people living with HIV the adherence to ART needed to achieve viral suppression referred to differs between 80 or 95% depending on publication. Here, viral suppression can also be monitored to indirectly estimate adherence.
In postnatal HIV transmission prophylaxis (former Option A) breastfed infants can be given ARVs as a prophylaxis, these children are not infected and consequently viral load can not be measured. Even without prophylaxis not all children get infected. The level of adherence needed to 'protect' is unclear.
240 000 annual new infections with existing operational adherence or lack of implemented programmes.... Now a fraction of that is during bf period. Could we do some type of sensitivity analysis based on existing trials?
Breastfeeding is associated with an additional risk 7 to 22% transmission. In turn, in cases of acute maternal infection, breastfeeding increases the VT of HIV to 29%.
Therefore, every mother seropositive for HIV should be advised to not breastfeed. At the same time, you must be aware that, in Brazil, is entitled to receive infant milk formula, at least until your child is 6 months old.
The pharmacological inhibition of lactation should be performed immediately after childbirth, using cabergoline 1.0mg orally in a single dose (two tablets of 0.5 mg orally).
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