Lactavih [HIV and breastfeeding] observatory

Why create the Lactavih observatory?

Until recently, in France and other high-income countries, breastfeeding was contraindicated for mothers living with HIV. This is now possible thanks to antiretroviral treatments. The new French guidelines for 2024 envisage breastfeeding provided that the viral load is undetectable in the long term (Pregnancy and HIV: desire for a child, care of the pregnant woman and prevention of mother-to-child transmission).

The Lactavih national observatory will assess the safety of breastfeeding in the context of HIV in order to guarantee that there is no upsurge in mother-to-child transmission.

What are the aims of the Lactavih observatory?

1. To assess the safety of breastfeeding for children born to mothers living with HIV in France.
2. To describe the number and characteristics of mothers living with HIV in France who breastfeed.
3. To describe any cases of infant infection during breastfeeding.

How do I report a case of breastfeeding in a woman living with HIV in the Lactavih observatory?

In order to enable comprehensive collection, the observatory relies on a simplified method of case reporting by practitioners via a secure certified platform.

Thus, there is no opening of centres, nor prior reporting by the investigators. No specific questionnaire will have to be completed and no additional samples will be taken; only data from medical records will be used.

The declaration of cases of breastfeeding in the mothers concerned may be made by any doctor (infectious disease specialist, obstetrician, paediatrician, general practitioner) or midwife directly or with the help of the technical staff of the COREVIH/CORESS, after informing the patients and obtaining their non-opposition.

The integration of data concerning the mother and her child in the Lactavih observatory will be carried out via a secure digital platform. This will allow you to upload first the declaration form, then all the information relating to breastfeeding monitoring data that will be requested from you by the Clinical Studies Technician (TEC).

The secure digital platform for the submission of medical information is accessible here.

The data will then be pseudonymised and transcribed into the database of the Lactavih observatory, which will be centralised at the Paris North West Clinical Research Unit (URC) at Bichat-Claude Bernard Hospital (AP-HP).

How is the follow-up of the mothers included in the study carried out?

Once the declaration has been made on the secure platform, a clinical research technician from the Paris North West Clinical Research Unit will use the documents uploaded and collected from healthcare professionals to complete the database with the mother’s follow-up data during breastfeeding.

The child will be monitored for up to 3 months after complete weaning from breastfeeding.