My email program is acting up so I can't find the original lactnet request however, the person looking for info on disease progression among breastfed and non-breastfed children might find the following abstract helpful.
Karleen Gribble
Australia

Breastfeeding and disease progression among perinatally HIV-infected children in Los Angeles County (LAC). 
Conf Retroviruses Opportunistic Infect 1997 Jan 22-26; 4th:197 (abstract no. 720)

Frederick T, Mascola L, Tucker D, Jackson J, George J; County of Los Angeles Department of Health Services, Los Angeles, CA. 


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Background: Because breastmilk is an established means of HIV transmission, HIV+ women in the US are counselled not to breastfeed. Women unaware of their HIV status, however, may unknowingly breastfeed. The effect of breastfeeding on HIV disease progression in perinatally HIV-infected infants was examined. 

Methods: An active surveillance study of all HIV-infected children in LAC began in 1988. Baseline data, including breastfed status (yes/no) and maternal injection drug use (IDU), and 6 mo. follow-up data are routinely collected on standardized forms. 

Results: As of 6/96, 197 HIV-infected children, evaluated for HIV after 1 month of age, were reported. Breastfeeding status was known for 138 (70%). The 59 children with unknown status were more likely Black (42% vs. 32% for known status, p is less than .05) and to have died (56% vs. 34%, p is less than .01). 43% of children with known status (60/138) were breastfed (BF). At last follow-up, non-breastfed (NBF) children compared to BF were more likely to have AIDS (58% vs. 48%), and PCP (31% vs. 18%) although statistical significance at p is less than .05 was not reached. Kaplan-Meier estimate of median time to AIDS was 42 mos. for NBF and 74 mos. for BF (gehan test, p is less than .10). Median time to death was 95 mos. for NBF and still undefined for BF with 75% survival probability at 55 months vs. 29 mos. for NBF. Recurrent diarrhea was more frequent in NBF vs. BF (16% vs. 3%, p is less than .05). Recurrent diarrhea was associated with time to AIDS (p is less than .001) and death (p is less than .001) in Cox-regression controlling for gestational age, birth year, race and mother's IDU. 

Conclusion: In this cohort of HIV-infected children, breastfeeding was not associated with earlier or more severe disease. Those breastfed had later AIDS onset, less PCP and less chronic diahrrea. Due to HIV transmission risk, however, policies recommending not to breastfeed should not change. 

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