Greetings to all,
For your info, here is the text of the WABA World AIDS Day Press
Release. If anyone would like a copy of the pdf file, with logo, please
let me know and I will send to you. Also available from the WABA website,
www.waba.org.my
Pamela
(interest declared: I'm the Co-coordinator of the WABA Task Force on HIV
and IF)
--------------------
PRESS RELEASE
For immediate release:
1 December 2005 (World AIDS Day)
New Studies Point To Reduced Risk Of Postnatal HIV
Transmission During Breastfeeding
As we mark World AIDS Day, it is sobering to contemplate that the greatest
burden of
the Human Immunodeficiency Virus (HIV) is borne by the developing world, where
more than 600 000 children are infected annually and where breastfeeding is
the norm.
Two decades have passed since the discovery that HIV could be passed
through breast
milk. The fear of postnatal transmission through breastfeeding, previously
estimated to
infect 14 – 16% of HIV-exposed babies, to cause one-third of all vertical
transmission, has undermined
confidence in breastfeeding in areas of the world where babies most need
its continuing protection and
where cessation of breastfeeding substantially increases infant mortality
from other diseases and
malnutrition.
Current global infant feeding guidelines recommend that babies should be
exclusively breastfed for the
first six months of life, and should continue to be partially breastfed
with the addition of appropriate
complementary foods for up to two years or beyond. Worldwide, over 10
million babies die every year,
60% of them from malnutrition and infections such as pneumonia and
diarrhoea, against which
breastfeeding is protective. This toll could be prevented if more mothers
were assisted to optimally
breastfeed their babies.
2005 saw publication of research results which modify our understanding of
postnatal HIV transmission.
In Zimbabwe untreated mothers and babies were followed up for 18 months,
giving careful attention to
how babies were fed at various periods of time after birth. Importantly,
this research distinguished
babies who received other foods and liquids besides breastmilk from those
being fed for 3 months on
breastmilk alone. Only 1% of babies breast fed exclusively for three months
were found to have been
infected between 6 weeks and 6 months of age. At eighteen months, the death
rate for exclusively breastfed
infants, whether or not HIV-infected, was less than half that of the
partially breastfed infants. Exclusive
breastfeeding rates increased dramatically, related to how often mothers
were exposed to information
about its benefits.
Growing recognition of the importance of breastfeeding has led to new
studies designed to reduce the
risk of postnatal HIV transmission by providing antiretroviral therapy to
mothers and/or their babies
while breastfeeding is maintained. Underscoring the importance of this line
of enquiry, research in 2005
also showed that uninfected and orphaned babies of infected mothers have a
far greater risk of morbidity
and mortality than the babies of healthy mothers. This provides additional
endorsement, if any were
needed, that the well-being of both mother and baby are inseparably
connected, and that programmes
designed only to reduce paediatric HIV while ignoring the health needs of
the mother are indefensible.
2005 marks a turning point in our ability to reduce the risk of HIV during
breastfeeding even as the
consequences of inadequate or no breastfeeding continue to be documented.
Babies need their mothers;
treatment designed to prolong the lives of HIV-infected women should be
provided in developing as
well as in developed countries. 90% of HIV-exposed babies are born into
settings where, for the most
part, breastmilk substitutes are neither acceptable, feasible, affordable,
sustainable nor safe and where
mortality from their use is likely to increase infant mortality four-fold.
90% of HIV+ mothers do not
know that they carry the virus. Of the remaining 10%, over 98% would not
infect their babies postnatally
if they were assisted to exclusively breastfeed, and the life expectancy of
babies born already infected
would be doubled. The child survival imperative is clear; exclusive
breastfeeding is one of the most
powerful and feasible antidotes to infant mortality available; the time is
right to renew support for
optimal breastfeeding for all women and their young children, in order to
reduce postnatal HIV
transmission and to keep the majority of babies born in HIV endemic
countries alive and healthy.
References:
Iliff PJ, Piwoz EG, Tavengwa NV, Zunguza CD, Marinda ET, Nathood KJ,
Moulton LH, Ward BJ, the
ZVITAMBO study group and Humphrey JH. Early exclusive breastfeeding reduces
the risk of postnatal
HIV-1 transmission and increases HIV-free survival. AIDS 2005, 19:699–708
Kuhn L, Kasonde P, Sinkala M, Kankasa C, Semrau K, Scott N, Tsai WY,
Vermund SH, Aldrovandi GM,
Thea DM. Does severity of HIV disease in HIV-infected mothers affect
mortality and
morbidity among their uninfected infants? Clin Infect Dis. 2005 Dec
1;41(11):1654-61. Epub 2005 Oct 27.
Piwoz EG, Iliff PJ, Tavengwa N, Gavin L, Marinda E, Lunney K, Zunguza C,
Nathoo KJ, the ZVITAMBO
Study Group and Humphrey JH. An Education and Counseling Program for Preventing
Breast-Feeding–Associated HIV Transmission in Zimbabwe: Design and Impact
on Maternal Knowledge
and Behavior. J. Nutr. 135: 950–955, 2005.
Shapiro RL, Ndung’u T, Lockman S, Smeaton LM, Thior I, Wester C, Stevens L,
Sebetso G, Gaseitsiwe S,
Peter T, and Essex M. Highly Active Antiretroviral Therapy Started during
Pregnancy or Postpartum
Suppresses HIV-1 RNA, but Not DNA, in Breast Milk. J Infect Dis. 2005 Sep
1;192(5):713-9. Epub 2005
Jul 27.
Shapiro RL, Holland DT, Capparelli E, Lockman S, Thior I, Wester C, Stevens
L, Peter T, Essex M, Connor
JD, Mirochnick M. Antiretroviral concentrations in breast-feeding infants
of women in Botswana receiving
antiretroviral treatment. J Infect Dis. 2005 Sep 1;192(5):720-7. Epub 2005
Jul 27.
Tavengwa N, Piwoz W, Gavin L, Zunguza C. Marinda E, Iliff P, Humphrey J and
the ZVITAMBO Study
Group, Education and counseling make a difference to infant feeding
practices and those feeding practices
make a difference to infant mortality, powerpoint presentation for Zimbabwe
PMTCT Partners Meeting,
2002.
Tozzi AE, Pazzotti P and Greco D 1990, Does breastfeeding delay progression
to AIDS in HIV-infected
children? Letter to the editor. AIDS 4:1493-94.
UNICEF Press release November 2004. World missing opportunity to reduce
mother-to-child HIV
transmission through exclusive breastfeeding.
For more information, kindly contact:
Pamela Morrison
WABA HIV and Infant Feeding Task Force Co-coordinator
Email : [log in to unmask]
Tel. No. : 44 1903 783 431
Liew Mun Tip
Deputy Director, WABA
Email : [log in to unmask]
Tel. No. : 604-6584816
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