Science at UM [S03-ep24]: Reconciling AIDS and breastfeeding
This week on A l’UM la science, 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, but also during childbirth and especially during breastfeeding.
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, conditional: first, the mother must be aware of her HIV status. Universal screening is now organized, but what about women who become infected during pregnancy or breastfeeding? Second, all women must be guaranteed access to antiretroviral treatment. 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 antiretroviral drugs or poor compliance with treatment can lead to a high viral load and therefore the risk of infecting the baby.
In 2016, the PROMISE scientific consortium, composed of 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 effectiveness of a drug called nevirapine or lamivudine. Administered during the first weeks of breastfeeding to infants born to HIV-positive mothers not treated with antiretrovirals, it very effectively reduced the risk of HIV transmission.
Since then, the same consortium has been working on a new intervention protocol combining screening of infants and mothers at different stages of pregnancy and breastfeeding, antiretroviral treatment for the latter and measurement of their viral load, and finally preventive treatment for infants throughout breastfeeding with the drug we have 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 of 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 participated in this study conducted in Burkina Faso and Zambia.
To go further:
- Read the press release New HIV prevention strategy could protect infants
- Read the publication in The Lancet
- Read also Lum's article A treatment to combine AIDS and breastfeeding
In the second part of the program, we invite you to listen to a new episode of Lumlu, the podcasts from Lum magazine, with Dans l’ile du cyclone(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 have the program, so let's get started!
Co-production: Divergence FM / University of Montpellier
Host: Lucie Lecherbonnier
Interview: Aline Périault / Lucie Lecherbonnier
Production: Alice Rollet
Listen to the program “A l’UM la science” on Divergence FM 93.9
Find UM podcasts now available on your favorite platform (Spotify, Deezer, Apple Podcasts, Amazon Music, etc.).