© 2012

Human Immunodeficiency Virus type 1 (HIV-1) and Breastfeeding

Science, Research Advances, and Policy

  • Athena P. Kourtis
  • Marc Bulterys


  • Presents the scope of HIV transmission from mother to infant through breast milk

  • Includes new discoveries of mucosal and innate immunity

  • Gives a current look at international research that attempts to balance HIV transmission prevention with retaining breast milk’s nutritional and immunologic benefits


Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 743)

Table of contents

  1. Front Matter
    Pages i-xvii
  2. Transmission of HIV-1 Infection and Other Viruses to the Infant Through Breastfeeding: General Issues for the Mother and Infant

    1. Front Matter
      Pages 1-1
    2. Mary Glenn Fowler, Athena P. Kourtis, Jim Aizire, Carolyne Onyango-Makumbi, Marc Bulterys
      Pages 3-25
    3. Claire L. Townsend, Catherine S. Peckham, Claire Thorne
      Pages 27-38
    4. Chin-Yih Ou, Susan Fiscus, Dennis Ellenberger, Bharat Parekh, Christine Korhonen, John Nkengasong et al.
      Pages 51-65
  3. Mechanisms of HIV-1 Transmission Through Breast Milk: Virology

    1. Front Matter
      Pages 67-67
    2. Susan A. Fiscus, Grace M. Aldrovandi
      Pages 69-80
    3. Koen K. A. Van Rompay, Kartika Jayashankar
      Pages 89-108
    4. Amanda H. Corbett
      Pages 109-118
  4. Mechanisms of HIV-1 Transmission Through Breast Milk: Immunology

    1. Front Matter
      Pages 119-119
    2. Philippe Lepage, Philippe Van de Perre
      Pages 121-137
    3. Steffanie Sabbaj, Chris C. Ibegbu, Athena P. Kourtis
      Pages 161-169
  5. Prevention of Breast Milk Transmission of HIV-1

    1. Front Matter
      Pages 171-171
    2. Athena P. Kourtis, Isabelle de Vincenzi, Denise J. Jamieson, Marc Bulterys
      Pages 173-183
    3. Barbara Lohman-Payne, Jennifer Slyker, Sarah L. Rowland-Jones
      Pages 185-195
    4. Monal R. Shroff, Eduardo Villamor
      Pages 205-213

About this book


The HIV pandemic continues to levy a heavy burden on the human race world-wide. The estimated number of people who became newly infected with HIV in 2009 was 2.6 million; most of these individuals live in Sub-Saharan Africa, followed by India and Southeast Asia. An estimated 370,000 new cases of pediatric infections occurred globally in 2009 (or more than 1,000 new infections every day), practically all of them through mother-to-child transmission. Up to 40% of all new infant HIV infections occur during breastfeeding. While breastfeeding by HIV-infected mothers is not recommended in the U.S. and other resource-rich settings where safe replacement feeding is easily available, the situation is different in many resource-limited settings, where replacement feeding is not safe or available and carries a high risk of infections (diarrhea, pneumonia) and infant malnutrition. Mothers in such settings are faced with a difficult dilemma: to breastfeed their infants in order to provide their infants with its many benefits (nutritional, immunologic, cognitive), but to also risk transmitting HIV. These challenges have prompted an intensive search for new prophylactic and therapeutic strategies in order to prevent infants from acquiring HIV infection through breastfeeding.


In this book, expert HIV researchers critically review every aspect of this highly evolving and topical subject. The opening chapters deal with the epidemiology, global magnitude and biologic mechanisms of HIV-1 transmission from mother to child through breastfeeding and include considerations of the virus (quantity, compartments, characteristics) and the host (genetic, immunity-innate, cellular, humoral). The effects of breastfeeding on the HIV-infected mother’s health and nutritional status, and the social and cultural issues associated with the practice of breastfeeding are also discussed. The next few chapters provide cutting-edge reviews of the latest approaches to prevention of HIV transmission to the infant through breastfeeding, including antiretroviral strategies, nutritional and immune-based approaches, and treatment of expressed breast milk. The remaining chapters provide a fascinating review of the many iterations this subject has received, as reflected in the several different sets of guidelines for infant feeding by HIV-infected mothers issued by the World Health Organization,  and a debate by leading scientists on whether HIV-infected mothers should breastfeed their infants-in resource-limited and in resource-rich settings. A comprehensive overview of the current state of implementing the new evidence for prevention of breastfeeding transmission of HIV all over the world is also presented.


Essential reading for the many disciplines of scientists and clinicians working on HIV/AIDS and other retroviruses, pediatricians, obstetricians/gynecologists, as well as all health-care professionals interested in expanding their understanding on the subject.

Editors and affiliations

  • Athena P. Kourtis
    • 1
  • Marc Bulterys
    • 2
  1. 1.School of MedicineEmory UniversityAtlantaUSA
  2. 2.and Prevention, Global AIDS Program - ChinaCenters for Disease ControlBeijingChina, People's Republic

Bibliographic information

  • Book Title Human Immunodeficiency Virus type 1 (HIV-1) and Breastfeeding
  • Book Subtitle Science, Research Advances, and Policy
  • Editors Athena P. Kourtis
    Marc Bulterys
  • Series Title Advances in Experimental Medicine and Biology
  • Series Abbreviated Title Advs Exp.Medicine,Biology
  • DOI
  • Copyright Information Springer Science+Business Media, LLC 2012
  • Publisher Name Springer, New York, NY
  • eBook Packages Medicine Medicine (R0)
  • Hardcover ISBN 978-1-4614-2250-1
  • Softcover ISBN 978-1-4939-5278-6
  • eBook ISBN 978-1-4614-2251-8
  • Series ISSN 0065-2598
  • Edition Number 1
  • Number of Pages XVII, 315
  • Number of Illustrations 0 b/w illustrations, 0 illustrations in colour
  • Topics Medicine/Public Health, general
    Maternal and Child Health
    Infectious Diseases
  • Buy this book on publisher's site
Industry Sectors
Health & Hospitals
Consumer Packaged Goods


From the reviews:

“The purpose is to convey recent information about HIV-1 transmission by breastfeeding, the virology and immunology around breastfeeding … and the public health implications of policy recommendations and research on HIV-infected women. … The book is most appropriate for academic researchers and clinicians, but some sections that are summaries of the known data would be relevant for general practitioners and medical residents. … I would recommend this as an excellent resource for what is known about the field of HIV-1 and breastfeeding.” (Natalie M. Neu, Doody’s Review Service, September, 2012)