Evaluation of Asthma/Atopic Outcomes in Relation to Breastfeeding Status Among HIV-Exposed Uninfected and HIV-Unexposed Uninfected Children

Objectives: Perinatal Human Immunodeficiency Virus (HIV) exposure may contribute to the development of asthma and atopic diseases through alterations in immune regulation. While an increased prevalence of atopic conditions has been reported among perinatally HIV-infected children, less is known about children who are HIV-exposed but uninfected (HEU). Breastfeeding provides important benefits for infants; until recently, breastfeeding was not recommended in women living with HIV (WLHIV). The focus of this study was the evaluation of asthma/atopic outcomes in relation to breastfeeding history among HEU and HIV-unexposed uninfected (HUU) children. Methods: A retrospective chart review (2005–2026) that examined pediatric medical records of children (M/F, 0–21 y/o) at an academic medical center (Brooklyn, NY) who were either perinatally HEU (N = 67) or HUU (N = 58). Data collected included infant-feeding practices (breast milk exposed or not exposed), demographics, medical and family history, and physician-diagnosed asthma or atopic conditions. Results: A medical diagnosis of atopy or asthma was associated with perinatal HIV exposure across both groups (p = 0.006) (Fisher exact test). HEU and HUU children were either breastfed (N = 13, 54, respectively) or not (N = 54, 4, respectively). However, when comparing exposure to breast milk versus no breast milk exposure, there was no association between perinatal HIV exposure and asthma or atopy in either group (p = 0.31, 0.19, respectively). Conclusions: Among both breast-milk-exposed and non-exposed children, no statistically significant difference in asthma/atopy prevalence between HEU and HUU children.