Human Immunodeficiency Virus and Breastfeeding: Clinical Considerations and Mechanisms of Transmission in the Modern Era of Combined Antiretroviral Therapy

Clin Perinatol. 2024 Dec;51(4):783-799. doi: 10.1016/j.clp.2024.08.001. Epub 2024 Sep 23.

Abstract

Combined antiretroviral therapy has significantly reduced perinatal human immunodeficiency virus (HIV) transmission risk through breastfeeding, prompting shifts in clinical guidance to support breastfeeding for women with HIV who have sustained viral suppression. This review examines the current evidence on HIV transmission via breast milk, including risk factors, mechanisms, and risk reduction strategies to inform patient-centered and evidence-driven clinical care.

Keywords: Antiretroviral therapy (ART); Breastfeeding; HIV; Risk reduction.

Publication types

  • Review

MeSH terms

  • Anti-HIV Agents / therapeutic use
  • Anti-Retroviral Agents / therapeutic use
  • Breast Feeding*
  • Female
  • HIV Infections* / drug therapy
  • HIV Infections* / transmission
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical* / prevention & control
  • Milk, Human* / virology
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy
  • Risk Factors

Substances

  • Anti-HIV Agents
  • Anti-Retroviral Agents