Erratum for Mandelbrot et al., Placental Transfer of Rilpivirine in an
            <i>Ex Vivo</i>
            Human Cotyledon Perfusion Model

Mandelbrot, Laurent; Duro, Dominique; Belissa, Émilie; Peytavin, Gilles

doi:10.1128/aac.01495-15

Cited by 1 publication

(1 citation statement)

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“…A French national cohort had 0.2% transmission with preconception cART vs. 0.4%, 0.9%, and 2.2% with first, second, or third trimester initiation. 14 The DHHS states that VL should be undetectable on cART before attempting conception. 15 In France (n=2615) and United Kingdom/Ireland (n=1894), transmission was 0.0% with preconception cART and undetectable VL near delivery.…”

Section: Risk Of Perinatal Hiv From Breastfeedingmentioning

confidence: 99%

Breastfeeding with HIV: An Evidence-Based Case for New Policy

Gross

Taylor²,

Tomori³

et al. 2019

J. Law. Med. Ethics

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To help eliminate perinatal HIV transmission, the US Department of Health and Human Services recommends against breastfeeding for women living with HIV, regardless of viral load or combined antiretroviral therapy (cART) status. However, cART radically improves HIV prognosis and virtually eliminates perinatal transmission, and breastfeeding's health benefits are well-established. In this setting, pregnancy is increasing among American women with HIV, and a harm reduction approach to those who breastfeed despite extensive counseling is suggested. We assess the evidence and ethical justification for current policy, with attention to pertinent racial and health disparities. We first review perinatal transmission and breastfeeding data relevant to US infants. We compare hypothetical risk of HIV transmission from breastmilk to increased mortality from sudden infant death syndrome, necrotizing enterocolitis and sepsis from avoiding breastfeeding, finding that benefits may outweigh risks if mothers maintain undetectable viral load on cART. We then review maternal health considerations. We conclude that avoidance of breastfeeding by women living with HIV may not maximize health outcomes and discuss our recommendation for revising national guidelines in light of autonomy, harm reduction and health inequities.

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Section: Risk Of Perinatal Hiv From Breastfeedingmentioning

confidence: 99%