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Should HIV-Positive Mothers Breast-Feed Their Babies? In Developing Countries, Sometimes the Answer is 'Yes,' Say Researchers on AIDScience.com
HIV-infected women in industrialized countries are generally counseled not to breast-feed their babies to avoid increasing the risk of transmission, and yet, in developing countries, the immunity breast milk offers against other devastating diseases might make the risk worth taking.
According to a peer-reviewed report published this week on AAAS's AIDScience Web site, "in developing countries around the world, women who have HIV and AIDS have to make the extremely difficult choice between dealing with the likelihood of sickness and death from common infections when their infants are not breast-fed, against the prospect of transmitting a lethal disease to (their children) through breast-feeding."
The results of a number of recent studies indicate that there are ways to reduce the chance of transmitting HIV, say the authors, Anna Coutsoudis and Hoosen M. Coovadia, both of the Department of Pediatrics and Child Health with the Nelson R. Mandela School of Medicine at the University of Natal in South Africa. The key is to follow certain guidelines. The authors cite the WHO/UNICEF/UNAIDS guidelines on HIV and infant feeding for women in developing countries: "'when replacement feeding is acceptable, feasible, affordable, sustainable and safe, avoidance of all breast-feeding by HIV-infected mothers is recommended; otherwise, exclusive breast-feeding is recommended during the first months of life.'" The authors conclude that risk of HIV infection in the first six months of life could be reduced to about five percent, if children are given only breast milk during that time, and no other foods or liquids. They further suggest that "reasonable clinical practices may reduce the transmission of HIV from mother to infant during breast-feeding," recommending that breast infections in the mothers and oral thrush in the infants be prevented or treated aggressively, and suggesting other options to reduce the risk of transmitting HIV to the infants.
The publication by Coovadia and Coutsoudis is the fourth paper to appear on http://www.aidscience.com since the site was launched in early June. Other authors on the site have addressed the question of whether a "universal" HIV-1 vaccine can be developed, and analyzed the progress and challenges still confronting researchers who study the wily virus.
The site is an outgrowth of the small NeuroAIDS Web site, which is devoted to the neurological impacts of AIDS. Its goal is to contribute to a reduction in the incidence of AIDS worldwide, according to Ellis Rubinstein, editor of Science. "AIDScience.com fits the AAAS mission of bringing the best scientific information to a broad audience that includes non-scientists," says Rubinstein He adds that Science magazine is "aggressively exploring the use of the Internet to provide new ways of disseminating information."
A second AAAS-sponsored Web site, Science's STKE, an experimental "signal transduction knowledge environment" for researchers involved in cell signaling; preceded the new AIDScience site.