Breastfeeding with HIV — SCE Infectious Diseases MCQ

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ModerateHIV MedicineBreastfeeding with HIVSCE Infectious Diseases

A 35-year-old woman with HIV (CD4 350, VL <50 on ART) plans to breastfeed. BHIVA 2025 supports informed choice about breastfeeding for women with HIV in the UK under specific conditions. What is the key condition?

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Correct answer: E — Sustained viral suppression (VL <50 copies/mL) on ART with good adherence — enabling informed supported breastfeeding with close monitoring

BHIVA 2025 pregnancy guidelines represent a significant shift: for the first time, they support informed choice about breastfeeding for women with HIV in the UK, provided specific conditions are met: sustained viral suppression (VL <50), excellent ART adherence, monthly maternal VL monitoring during breastfeeding, and engagement with multidisciplinary support. This reflects the extremely low transmission risk with undetectable VL (estimated <0.3% over 12 months in the PROMISE trial). Formula feeding remains the zero-risk option and should be supported without stigma.

Reference: BHIVA 2025 – HIV in pregnancy and breastfeeding guidelines