7.1.3 ARV drugs and duration of breastfeeding

Consolidated ARV guidelines, June 2013

Key research gaps

  • the risk of postpartum transmission in the context of ART, with variable duration of breastfeeding and different programme settings;
  • short- and long-term infant health outcomes related to prolonged, low-dose exposure to ARV drugs (especially EFV and TDF) through breast-milk, including neurodevelopmental outcomes, nutritional status (including micronutrients), bone metabolism and growth; and
  • interventions to improve adherence to postnatal ARV drugs and breastfeeding and whether initiating lifelong ART in all pregnant and postpartum women enhances adherence to ARV drugs during breastfeeding, which would enable women with HIV to breastfeed without any time restriction.