Infant feeding and HIV-1 transmission.

Anna Coutsoudis and colleagues present a potentially important piece of the puzzle concerning the transmission of HIV-1 through breast-feeding in the first few months of life. Breast-feeding poses a substantial risk of acquiring HIV-1 infection for the baby of an HIV-1-infected mother. Samples from 549 infants were tested by HIV-DNA PCR on day 1 and at ages 1 month and 3 months. Results revealed that the percentages of infection were similar for the three groups between 1 month and 3 months, and that the real increase in rate of infection occurred after the first month of life. This suggests that there may be a protective early effect of exclusive breast-feeding and that hence a breast-feeding HIV-1-infected mother should avoid giving any other foods for at least the first 3 months of life. Results in this study highlight the need for re-evaluation of the role of breast-feeding in the transmission of HIV-1.