# BREASTFEEDING AND TRANSMISSION OF HIV

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 1994 · $374,998

## Abstract

Vertical transmission of HIV is a major problem in many parts of the
world, but particularly in Africa.  Estimates of transmission rates have
ranged from 13% to 48% in various studies, but little is known about the
relative contributions of in utero, perinatal, and postnatal
transmission.  Recent studies have demonstrated the occurrence of
postnatal transmission, presumably through breast milk, in the setting
of acute maternal postpartum infection.  The objective of the current
proposal is to determine the frequency of breast milk transmission of HIV
among infected mothers to their infants in Nairobi, Kenya.

The study will be conducted as a prospective randomized clinical trial
comparing infant HIV infection rates between breast-fed and formula-fed
groups.  After informed consent is obtained, pregnant HIV seropositive
women attending an antenatal clinic will be randomly assigned to one of
two groups.  Group I women will be counselled to breast-feed their
infants in accordance with current Kenyan Ministry of Health and World
Health Organization recommendations.  Group II women will be counselled
to formula feed and a supply of formula will be provided.  Women will be
evaluated for demographic and medical historical variables, HIV related
disease stage, CD4 levels, and quantitative HIV titers in peripheral
blood lymphocytes (PBLs) and plasma using polymerase chain reaction (PCR)
amplification.  Infants will be evaluated from birth to two years for
morbidity, mortality, and presence of serum HIV IgG and IgA, and HIV DNA
in PBLs using PCR assays.  The presence and quantity of HIV DNA and RNA
in colostrum and breast milk will be assessed among breast feeding
mothers.

The rate of HIV infection in infants in Group I and Group II will be
compared and an attributable risk defined.  The association between HIV
infection in infants and potential correlates, including maternal viral
titers in PBLs and breast milk, CD4 levels, HIV related disease, duration
of exclusive vs partial breast feeding, nipple pathology, or infant oral
pathology will be evaluated.  Excess morbidity and mortality attributable
to formula feeding will be defined after stratifying infants into
infected and uninfected groups.

Knowledge regarding the frequency of breast milk transmission of HIV will
be valuable for counselling pregnant women, formulation of public health
policy in Kenya and other countries, and development of rational
intervention strategies.

## Key facts

- **NIH application ID:** 2198857
- **Project number:** 5R01HD023412-07
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **SAM.gov UEI:** HD1WMN6945W6
- **Principal Investigator:** JOAN K KREISS
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 1994
- **Award amount:** $374,998
- **Award type:** 5
- **Project period:** 1987-09-30 → 1997-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/2198857

## Citation

> US National Institutes of Health, RePORTER application 2198857, BREASTFEEDING AND TRANSMISSION OF HIV (5R01HD023412-07). Retrieved via MORVS 2026-10-25 from https://api.morvs.ai/grant/nih/2198857. Licensed CC0.

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