Malaria Drug Could Block Mother-Child HIV Spread

New research offers hope that a cheap and widely available malaria drug may be used to reduce mother-to-child transmission of HIV. A report in the November 23rd issue of the journal AIDS (2001;15:2205-2207) suggests that women may be able to reduce the risk of transmitting HIV to their child via breast milk by taking the anti-malarial drug chloroquine. In laboratory tests of breast cells and in samples from women taking chloroquine, Dr. Johan R. Boelaert of Algemeen Ziekenhuis St-Jan in Brugge, Belgium, and colleagues found that the drug "accumulates greatly" in breast-milk cells.

HIV medications can drastically reduce the risk that an HIV-positive mother will pass the virus to her baby during delivery. But if an HIV-positive mother breast-feeds her child, she runs the risk of infecting the child. In fact, breast-feeding may account for up to a half of all cases of mother-to-child HIV transmission. But forgoing breast-feeding may be difficult for practical and societal reasons for women in many poor countries. Since HIV replicates in breast-milk cells and chloroquine has been shown to slow HIV replication, women who take chloroquine while breast-feeding may be able to reduce levels of HIV in their milk. The research is preliminary, but it "warrants further study," Boelaert's team points out. The authors note that chloroquine is cheap, widely available and causes few side effects at low doses. Another advantage, they add, is that the drug does not carry any social stigma.

The researchers are planning a study in sub-Saharan Africa to see what effect chloroquine has on HIV levels in the breast-milk of HIV-positive women. "I think that Dr. Boelaert's study is of great interest," said Dr. Andrea Savarino, of the University of Turin in Italy. Savarino is the lead author of another study that found chloroquine has anti-HIV properties in the laboratory. If further research demonstrates that chloroquine reduces the risk of mother-to-child transmission, the impact on the AIDS epidemic "would be great," according to Savarino. "Chloroquine is the cheapest of any drug having anti-HIV activity and could therefore be afforded by developing countries where breast-feeding is an important route of HIV transmission," Savarino said.

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