UK - Breastfeeding, No vertical HIV transmissions 2012 -2021

[Jim Allen]

More evidence to support breastfeeding.

Polly Clayden, HIV i-Base - https://i-base.info/htb/45757

In Short:
There were no vertical transmissions in the UK among women living with HIV supported to breastfeed from 2012 to 2021  – according to data presented at the BHIVA spring conference 2023.

The current rate of vertical transmission from women in the UK diagnosed with HIV is less than 0.3%. BHIVA recommends formula-feeding to eliminate the risk of post-natal transmission. But the guidelines also say that women who are virologically suppressed on ART with good adherence may be supported to breastfeed (supported breastfeeding).

Among 8,513 live birth deliveries, 203 (2.4%) women were confirmed supported to breastfeed, with some breastfeeding more than one infant.

In 46 cases, monthly testing was known not to be applicable due to breastfeeding duration. Where applicable, 80.2% (77/96) of mother-infant pairs had monthly testing according to BHIVA guidelines. In 11 cases, reasons for not having monthly testing included: scheduling miscommunications, parental requests, and long-term maternal virological suppression. Attendance issues were reported in 32.5% (25/77) of cases with monthly testing.

For most women, cessation of breastfeeding was part of a plan to stop. But in 10 cases, breastfeeding was stopped due to maternal viral load rebound.

Of 150 infants, 106 had a negative antibody result at 18 months of age or older,  five were discharged based on negative antibody result dated less than 18 months, 34 were awaiting confirmatory testing and five were lost to follow-up.