Preventing Mother-to-Baby Transmission

Kashuba is collaborating with Charles van der Horst, a professor of medicine at UNC-Chapel Hill, on a study in Malawi that examines the use of drugs to prevent transmission of HIV from mother to infants.

To prevent mother-to-baby transmission, physicians use antiretroviral drugs to keep down the amount of the virus in women during pregnancy and do not allow HIV-infected mothers to breastfeed their infants. Kashuba says that approach has been very effective in North America but is not practical in developing countries, where access to antiretroviral therapy often is limited to patients with weak immune systems. Also, factors such as financial restraints, lack of clean water, and social stigma leave many mothers with no choice but to breastfeed their infants.

“It becomes very complicated in developing countries because there have been studies that have shown that even though babies become infected with HIV [through breastfeeding], if women don’t breastfeed, more babies die because of all the other benefits that breastfeeding gives to babies.”

The collaboration between Kashuba and van der Horst is looking into the possibility of giving HIV-infected mothers antiretroviral drugs only during the first six months of their babies’ lives, when the infants need to be breastfed. If that treatment effectively prevents transmission, it would allow women in developing countries who are not on long-term antiretroviral therapy to breastfeed without passing the virus to their babies.

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