HIV-positive breast-feeding mothers with good immune health who take triple-drug antiretroviral (ARV) treatment nearly eliminate their risk of transmitting the virus to their babies. To reach these conclusions, researchers from the multicomponent PROMISE study, which began in 2010, enrolled 2,431 pairs of mothers with HIV and their HIV-negative infants at sites in South Africa, Malawi, Tanzania, Uganda, Zambia, Zimbabwe and India between June 2011 and October 2014.

Results were presented at the 21st International AIDS Conference in Durban, South Africa (AIDS 2016).

For the most part, the women had no symptoms of HIV infection and had relatively high CD4 counts.

The women and their newborns were randomly assigned either to receive triple-ARV treatment for the mothers through the study’s follow-up period along with daily doses of Viramune (nevirapine) for the infant until six weeks after birth or receive triple-ARV treatment for the mother for one week after delivery along with daily doses of Viramune for the infant starting a week after birth through the end of the study’s follow-up period.

Women and their infants were followed for, whichever came first: 18 months or until the mothers stopped breast-feeding, which took place on average 15 months after they gave birth.

The rate of transmission from mother to child was very low in both study arms and did not differ: 0.3 percent when the babies were 6 months old and 0.6 percent by their first birthday. Previous research has shown that the risk of transmitting HIV through breast-feeding without taking ARVs is 15 to 45 percent.

The two study arms had similarly low rates of adverse health events among the mothers and babies. And in countries where infant mortality can be high, almost 99 percent of the babies in this study survived their first year.

To read a press release about the study, click here