Babies resistant to mothers’ ARVs

Babies as young as six months have developed resistance to HIV drugs after breast feeding, according to a recent survey.

The study carried out by the Kenya Medical Research Institute in Kisumu assessed the effectiveness of various HIV drug regimens in preventing mother-to-child transmission during pregnancy and thereafter.

According to the research findings, putting a HIV positive woman on anti-retrovirals (ARVs) significantly reduced the risk of infecting her child during delivery or shortly after.

However, 24 infants in the study were infected with HIV either during delivery or within the first six months of breastfeeding.

Further analysis, said the study carried out in collaboration with the US Centre for Disease Control and Prevention, Kisumu, showed that the infants developed resistance to particular ARVs which were being used by the mothers.

The report given last week concluded that ingestion of anti-retroviral drugs through breast milk may have contributed to the emergence of HIV drug resistance in the infants.

The new findings will be significant for doctors when deciding on which antiretrovirals to prescribe to HIV infants.

“Programmes providing maternal anti-retroviral therapy during breastfeeding and those caring for infants exposed to anti-retrovirals through breast milk will need to be cognisant of this issue and consider monitoring these infants more closely and tailoring their treatment accordingly,” the researchers said.

This could further complicate the treatment of HIV positive children since only a handful of World Health Organisation (WHO) recommended ARVs are available in formulations that are affordable, feasible or acceptable for use in infants and young children.

Only 11 out of the 18 drugs used to treat adult HIV infection have indications, clear dosage or package inserts for use in children according to the WHO.