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Question

This is regarding pediatric hiv 1)iap has recommended few simple measures to reduce breast milk hiv transmission like a-keep ebm standing for fewq hours b-boiling and pasteurising breast milk c-frrezing my qustion is how much feasible and useful they are ? Do they really reduce the viral load to significant extent/ what is your experiance? 2)iam working in an hiv project where we regularly do baseline investigation and dna pcr the trial is related to nevirapine where we give 6 week nevirapine in babies enrolled in randomised cohort. It has been observed that many babies develop anaemia or neutropenia or both where neither of these side effect has been mentioned as per as i know.will you please guide me? 3) does mother receiving zidovidine antenataly will cause anaemia in baby?

Answer

Are you giving nevirapine for 6 weeks or is it zidovudine for six weeks. NVP usually has a half life for over 3 weeks and hence single dose is usually enough. Also 6 weeks of single dose NVP may lead to resistance since the mutation required is only one whereas for AZT, multiple mutations are required before the drugs becomes resitant.
There are studies that have found that pasteurization of breast milk kills the HIv virus can this has been proved several times in South Africa. However the problem is of compliance as it is difficult to express the milk in the first place and then storing and boiling. Here formula feeds becomes easier to give.
AZT in mother can lead to anemia, asymptomatic elevation of liver enzymes in the baby.
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