A l'UM la science [S03-ep24]: Reconciling AIDS and breastfeeding

This week in A l'UM la science Nicolas Nagot, a researcher in the pathogenesis and control of chronic and emerging infections laboratory, tells us how his research enables HIV-positive mothers to breastfeed their children without transmitting HIV. A program co-produced with Divergence FM and broadcast every Wednesday at 6pm on 93.9.

130,000 is the number of babies worldwide who contracted HIV through maternal transmission in 2022, according to UNAIDS. A woman living with HIV can transmit the virus to her child not only during pregnancy, but also during childbirth and, above all, while breast-feeding.

Without antiretroviral treatment, the risk of mother-to-child transmission is between 15-30%; with treatment, it drops to less than 1%.

This incredible effectiveness is, of course, subject to a number of conditions: firstly, the mother must be aware of her serological status: universal screening is now organized, but what about women infected during pregnancy or while breast-feeding? Secondly, access to anti-retroviral treatment must be guaranteed for all. Finally, HIV-positive mothers must have a viral load of less than or equal to 1,000 copies per micro-liter of blood. However, resistance to anti-retrovirals or poor compliance with treatment can lead to the maintenance of a high viral load, and therefore the risk of contamination of the baby.

In 2016, the PROMISE scientific consortium, comprising researchers from the University Hospital of Lusaka in Zambia, the Muraz Center in Burkina Faso, the University of Bergen in Norway, Inserm and the University of Montpellier, demonstrated the efficacy of a drug called nevirapine or lamivudine. Administered during the first weeks of breastfeeding to infants born to HIV-positive mothers not treated with antiretroviral drugs, it was highly effective in reducing the risk of HIV transmission.

This same consortium has since worked on a new intervention protocol combining screening of infants and mothers at different stages of pregnancy and breastfeeding, anti-retroviral treatment of the latter and measurement of their viral load, and finally preventive treatment of infants throughout breastfeeding with the drug just mentioned. Their results were published in the Lancet on March 11, 2024.

Our guest Nicolas Nagot is a researcher at Inserm, the French national institute for health and medical research, in the pathogenesis and control of chronic and emerging infections laboratory. He is also Head of the Medical Information, Epidemiology and Health Data Department (SIMED) at Montpellier University Hospital, and took part in this study carried out in Burkina-Faso and Zambia.

In the second half of the program, we invite you to listen to a new episode of Lumlu, Lum magazine's podcasts, with Dans l'ile du cyclone. Thomas Ibanez, researcher at the Amap laboratory, studies how tropical forests resist these devastating winds.

At UM la science you've got the program, here we go!

Coproduction: Divergence FM / University of Montpellier
Animation: Lucie Lecherbonnier
Interview : Aline Périault / Lucie Lecherbonnier
Directed by : Alice Rollet

Listen to the program "A l'UM la science" on Divergence FM 93.9