Stavudine concentrations in women receiving postpartum antiretroviral treatment and their breastfeeding infants

J Acquir Immune Defic Syndr. 2012 Aug 15;60(5):462-5. doi: 10.1097/QAI.0b013e31825ddcfa.


First-line antiretroviral treatment regimens in resource-limited settings used in breastfeeding mothers often include stavudine (d4T). Limited data describing d4T concentrations in breast milk are available. We analyzed d4T concentrations in 52 mother-infant pairs using ultra-performance liquid chromatography-tandem mass spectrometry (lower limit of quantification: 5 ng/mL in plasma, 20 ng/mL in breast milk). Median (interquartile range) d4T concentrations were 86 (36-191) ng/mL in maternal plasma, 151 (48-259) ng/mL in whole milk, 190 (58-296) ng/mL in skim milk, and <5 (<5 to <5) ng/mL in infant plasma. Although d4T is concentrated in breast milk relative to maternal plasma, the infant d4T dose received from breast milk is very small and not clinically significant.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Anti-HIV Agents / administration & dosage*
  • Anti-HIV Agents / pharmacokinetics*
  • Breast Feeding*
  • Chromatography, Liquid
  • Female
  • HIV Infections / drug therapy*
  • Humans
  • Infant
  • Infant, Newborn
  • Milk, Human / chemistry*
  • Postpartum Period
  • Stavudine / administration & dosage*
  • Stavudine / pharmacokinetics*
  • Tandem Mass Spectrometry


  • Anti-HIV Agents
  • Stavudine