What question did this study set out to answer?

This research aims to determine the relationship between maternal plasma and breastmilk HIV RNA levels and the risk of HIV transmission during breastfeeding.

March 18, 2026JAIDS Journal of Acquired Immune Deficiency SyndromesOpen Access

Associations of Plasma and Breast Milk HIV RNA and Tenofovir Concentrations with Risk of Postnatal HIV Transmission during Breastfeeding Among Women with and without ARV Exposure

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This research aims to determine the relationship between maternal plasma and breastmilk HIV RNA levels and the risk of HIV transmission during breastfeeding.
Conducted a case-control study within the IMPAACT PROMISE trial.
Matched each maternal-infant pair with positive HIV tests to two controls with negative tests.
Assayed maternal plasma and breastmilk for HIV RNA and tenofovir concentrations.
Calculated odds ratios using conditional logistic regression.
90% of maternal cases had detectable plasma RNA VL above the lower limit compared to 45% of controls.
Odds of vertical HIV transmission were 9 times higher for plasma RNA VL above limits.
21% of cases on tenofovir had detectable levels in plasma and breastmilk versus 84% in controls.
A log10 increase in tenofovir concentrations reduced the odds of being a case by 90%.

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Implication

A case-control study shows higher HIV RNA levels increase transmission risk during breastfeeding, suggesting key implications for treatment.

Cite This Study

Owor et al. (2026) studied this question.

synapsesocial.com/papers/69ba44154e9516ffd37a5ef2 https://doi.org/10.1097/qai.0000000000003863

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Implication

A case-control study shows higher HIV RNA levels increase transmission risk during breastfeeding, suggesting key implications for treatment.

Associations of Plasma and Breast Milk HIV RNA and Tenofovir Concentrations with Risk of Postnatal HIV Transmission during Breastfeeding Among Women with and without ARV Exposure

Key Points

Discussion

Implication

Cite This Study

Associations of Plasma and Breast Milk HIV RNA and Tenofovir Concentrations with Risk of Postnatal HIV Transmission during Breastfeeding Among Women with and without ARV Exposure

Key Points

Discussion

Implication

Cite This Study

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