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Tenofovir may prevent breast milk HIV transmission
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By Deborah Mitchell
BANGKOK (Reuters Health) - Studies in monkeys suggest that chronic oral tenofovir disoproxil fumarate (DF) therapy can reduce the risk of maternal-infant HIV infection via breast milk. Daily treatment may also be effective in reducing HIV infection in high-risk adult groups, such as commercial sex workers and men who have sex with men.
Dr. Koen Van Rompay of the University of California, Davis and colleagues at Gilead Sciences, Foster City, California, developed an animal model in which infant macaques were repeatedly bottle-fed with a solution containing low doses of virulent simian immunodeficiency virus (SIV).
The infants were exposed to SIV during the first week of life and those that did not become infected were exposed again after 1 month. Each inoculation period consisted of 15 feedings, three times daily for 5 consecutive days.
One group was given tenofovir DF syrup starting 1 day before and continuing until 1 day after the SIV exposure periods. Tenofovir was administered orally in doses pharmacokinetically equivalent to the 8 mg/kg regimen used in pediatric trials and the 300 mg used in adults.
Twenty of the 22 untreated macaques became viremic after two rounds of SIV inoculations, whereas, 3 of 6 tenofovir-treated animals were still uninfected at 3 months of age. The treatment was very well tolerated.
Thus, Dr. Van Rompay concluded. "chronic treatment of breast-feeding infants with tenofovir DF is very likely to reduce the chance of HIV transmission from breast-feeding."
"The results are also very relevant to HIV-negative adults who are at high-risk who can also be given a single dose of tenofovir DF per day to reduce the risk of sexual transmission," he concluded. The feasibility of this prevention strategy is currently under investigation in clinical trials.
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