Science at UM [S03-ep24]: Balancing HIV and Breastfeeding

[Podcast] - Published on April 25, 2024 in Science and Society

This week on "Science at UM," Nicolas Nagot, a researcher at 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 to them. A program co-produced with Divergence FM and broadcast every Wednesday at 6 p.m. on 93.9.

According to UNAIDS, 130,000 babies worldwide contracted HIV through mother-to-child transmission in 2022. A woman living with HIV can transmit the virus to her child during pregnancy, as well as during childbirth and, most importantly, while breastfeeding.

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

This incredible effectiveness, of course, depends on certain conditions: first, the mother must be aware of her HIV status; while universal screening is now in place, what about women who become infected during pregnancy or while breastfeeding? Second, access to antiretroviral treatment must be guaranteed for all. Finally, the viral load of HIV-positive mothers must be less than or equal to 1,000 copies per microliter of blood; however, resistance to antiretrovirals or poor adherence to treatment can lead to a persistently high viral load and thus the risk of transmission to the baby.

In 2016, the PROMISE scientific consortium—comprising researchers from the Lusaka University Hospital in Zambia, the Muraz Center in Burkina Faso, the University of Bergen in Norway, Inserm, and the University of Montpellier—demonstrated the effectiveness of a drug, nevirapine or lamivudine. When administered during the first weeks of breastfeeding to infants born to HIV-positive mothers not receiving antiretroviral treatment, it very effectively reduced the risk of HIV transmission.

Since then, this same consortium has been working on a new intervention protocol that combines screening of infants and mothers at various stages of pregnancy and breastfeeding, initiating antiretroviral treatment for the mothers and monitoring their viral load, and finally, providing preventive treatment to infants throughout the breastfeeding period using the medication we just discussed. Their results were published in The Lancet on March 11, 2024.

Our guest, Nicolas Nagot, is a researcher at Inserm, the French National Institute of Health and Medical Research, in the Pathogenesis and Control of Chronic and Emerging Infections laboratory. He is also head of the Department of Medical Information, Epidemiology, and Health Data (SIMED) at Montpellier University Hospital, and he participated in this study conducted in Burkina Faso and Zambia.

In the second half of the program, we invite you to listen to a new episode of Lumlu, the podcast from Lum magazine, titled “On the Island of the Cyclone.” Thomas Ibanez, a researcher at the Amap laboratory, studies how tropical forests withstand these devastating winds.

At UM Science, you’ve got the program—let’s get started!

Co-production: Divergence FM / University of Montpellier
Host: Lucie Lecherbonnier
Interview: Aline Périault / Lucie Lecherbonnier
Production: Alice Rollet

Tune in to the show “A l’UM la science” on Divergence FM 93.9

Keywords: Science at UM, Research, Science, Company