Observational research demonstrates the need for effective prophylaxis in neonates and children, indicating the importance of antiretroviral drugs during breastfeeding.
As there is a risk of HIV transmission throughout breastfeeding, if ePNP is initiated - guided or not by maternal HIV viral load -, it should be administered until breastfeeding has ceased completely. Determining the plasma/tissue level of antiretroviral drugs or broadly neutralizing HIV antibodies (bNAbs) required to protect against HIV acquisition through breastfeeding is a research priority. Long-acting antiretroviral drugs are currently unavailable for prophylaxis or treatment in neonates and children. Several studies are currently evaluating the safety and pharmacokinetics of bNAbs in neonates and children exposed to HIV. These bNAbs could represent a significant advance in the prevention of postnatal HIV acquisition in the future.
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Perre et al. (2025) studied this question.
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