Concentrations of Tenofovir and Emtricitabine in Breast Milk of HIV-1-Infected Women in Abidjan, Côte d’Ivoire, in the

The aim was to evaluate emtricitabine (FTC) and tenofovir (TFV) neonatal ingestion through breast milk. Median TFV and FTC breast milk doses represented 0.03 % and 2%, respectively, of the proposed oral infant doses. Neonatal simulated plasma concentrations were extremely low for TFV but between the half-maximal inhibitory concentration and the adult minimal expected concentration for FTC. The rare children who will acquire HIV despite TDF-FTC therapy will need to be monitored for viral resistance acquisition. For prevention of mother-to-child transmission (PMTCT) of HIV in resource-limited settings, single-dose nevirapine (sd-NVP) has been commonly administered at the start of labor up to now according to previous World Health Organization (WHO) guidelines. However, the use of sdNVP results in re-sistance mutations in 15 to 70 % of women, at 4 to 6 weeks postpartum, compromising the success of subsequent treat-ments with NVP in mothers and children (1, 7). Adding a single dose of tenofovir disoproxil fumarate (TDF)-emtricitab-ine (FTC) reduced these resistance mutations by half (2, 10)