Resistance mutation patterns in plasma and breast milk of HIV-infected women receiving highly-active antiretroviral therapy for mother-to-child transmission prevention

Mother-to-child transmission via breastfeeding accounts for a relevant proportion of pediatric HIV infections in resource-limited countries. Highly-active antiretroviral therapy (HAART) prophylaxis administered to breastfeeding mothers has been proposed as a possible strategy to prevent postnatal transmission and, indeed, the recently reported results of two studies assessing this approach are encouraging. One of the possible obstacles to the use of this preventive strategy is that the different penetration of antiretroviral drugs into the breast milk could favour the emergence of resistance and be associated to the transmission of resistant strains.