IngentaConnect Impact of chloroquine on viral load in breast milk

Authors: Semrau, Katherine¹; Kuhn, Louise²; Kasonde, Prisca³; Sinkala, Moses⁴; Kankasa, Chipepo⁵; Shutes, Erin⁶; Vwalika, Cheswa⁶; Ghosh, Mrinal⁷; Aldrovandi, Grace⁸; Thea, Donald M.⁹

Source: Tropical Medicine & International Health, Volume 11, Number 6, June 2006 , pp. 800-803(4)

Publisher: Blackwell Publishing

Abstract:

Summary

The anti-malarial agent chloroquine has activity against HIV. We compared the effect of chloroquine (n = 18) to an anti-malarial agent without known anti-HIV-activity, sulfadoxine-pyrimethamine (n = 12), on breast milk HIV RNA levels among HIV-infected breastfeeding women in Zambia. After adjusting for CD4 count and plasma viral load, chloroquine was associated with a trend towards lower levels of HIV RNA in breast milk compared with sulfadoxine-pyrimethamine (P = 0.05). Higher breastmilk viral load was also observed among women receiving presumptive treatment for symptomatic malaria compared with asymptomatic controls and among controls reporting fever in the prior week. Further research is needed to determine the potential role of chloroquine in prevention of HIV transmission through breastfeeding.

Keywords: breastfeeding; breastmilk viral load; chloroquine; fever; HIV; malaria; MTCT; sulfadoxine-pyrimethamine

Document Type: Research article

DOI: 10.1111/j.1365-3156.2006.01645.x

Affiliations: 1: Center for International Health & Development, Boston University School of Public Health, Boston, MA, USA 2: Gertrude H. Sergievsky Center and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA 3: Department of Obstetrics and Gynecology, University Teaching Hospital, Lusaka, Zambia 4: Lusaka District Health Management Team, Lusaka, Zambia 5: Department of Pediatrics, University Teaching Hospital, Lusaka, Zambia 6: Department of Global Health, Emory University, Atlanta, GA, USA 7: Department of Pediatrics, University of Southern California, Los Angeles, CA, USA 8: Department of Pediatrics, University of Southern California, and Department of Infectious Disease, Children's Hospital Los Angeles, Los Angeles, CA, USA 9: Department of International Health and Center for International Health & Development, Boston University School of Public Health, Boston, MA, USA

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