Breastfeeding while on Atripla

Question

Hi Dr. Henry I am 24weeks pregnant and on Atripla. My CD4 count is above 500 and my viral load is undetectable. Baby is healthy and I have a real smooth pregnancy. I Know research says one should not breast feed when HIV positive however I would like to know if there is a chance at all if I can breast feed baby when she is born without passing the virus to her.

Answer

Breast feeding babies born to HIV+ women is generally not recommended. That being said the risk for transmission is generally low if the mother is on treatment (including Atripla)and has an HIV level < 50 copies/ml). If clean water/formula is consistently available bottle feeding is still recommended in most cases to keep the risk as close to zero as possible. Safety of breast feeding for women doing well on HIV treatment is under intense study. In addition, the safety of various HIV medications to newborns (such as the efavirenz in Atripla) still needs more data to be able to endorse without any reservations.Recommend discussing with your HIV provider/OB doctor who would be aware of your HIV /health status in order to make best individualized recommendation. KH