Evidence map›Paper›PMID 42359117›Full record

ArticleWellcome open research2026

Breastmilk transfer of cabotegravir and infant safety outcomes in mothers on cabotegravir for HIV prevention in Lilongwe, Malawi: A protocol for an observational pharmacokinetic study, CABMILK Study.

Mphatso S Kantonya, Clifford G Banda, Mayamiko D Kapulula, Steven Munharo, Hellen D Chavula, Vincent K Phiri, Diksha Patel, Friday Saidi, Mina Hosseinipour, Fiona Cresswell and 2 more

Abstract read
In one paragraph

Article in Wellcome open research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Mphatso S KantonyaMalawi Liverpool-Wellcome Research Programme, Lilongwe, Malawi.ORCID https://orcid.org/0009-0003-7896-3659
Clifford G BandaMalawi Liverpool-Wellcome Research Programme, Lilongwe, Malawi.ORCID https://orcid.org/0000-0002-0757-5259
Mayamiko D KapululaMalawi Liverpool-Wellcome Research Programme, Lilongwe, Malawi.
Steven MunharoMalawi Liverpool-Wellcome Research Programme, Lilongwe, Malawi.
Hellen D ChavulaMalawi Liverpool-Wellcome Research Programme, Lilongwe, Malawi.
Vincent K PhiriMalawi Liverpool-Wellcome Research Programme, Lilongwe, Malawi.ORCID https://orcid.org/0000-0001-9173-3426
Diksha PatelMalawi Liverpool-Wellcome Research Programme, Lilongwe, Malawi.ORCID https://orcid.org/0009-0004-2306-782X
Friday SaidiThe University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Mina HosseinipourThe University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.ORCID https://orcid.org/0000-0003-2174-313X
Fiona CresswellBrighton and Sussex Medical School, Brighton, England, UK.
Catriona WaittUniversity of Liverpool Department of Women's and Children's Health, Liverpool, England, UK.
Victor MwapasaMalawi Liverpool-Wellcome Research Programme, Lilongwe, Malawi.ORCID https://orcid.org/0000-0002-2748-8902

Funding

Wellcome Trust
6 · The paper itself

Abstract

Background: Long-acting injectable cabotegravir (CAB-LA) is highly effective for HIV pre-exposure prophylaxis (PrEP). However, lactating women have been underrepresented in pharmacokinetic and safety studies despite their elevated risk of HIV acquisition and potential postnatal transmission through breastfeeding. Data on cabotegravir transfer into breast milk and infant exposure remain limited. The Cabotegravir in Mother-Infant Pairs and Lactation Pharmacokinetics (CABMILK) study addresses this evidence gap to inform safe and equitable PrEP delivery within maternal and child health services in Malawi. Objectives: The primary objective is to quantify cabotegravir transfer into breast milk and estimate infant exposure following maternal use of CAB-LA for PrEP. Secondary objectives are to describe and contextualise infant safety outcomes, including growth, developmental status, and adverse events-among infants whose mothers receive CAB-LA, oral PrEP (tenofovir disoproxil fumarate/emtricitabine), or no PrEP, and to explore maternal factors associated with breast milk drug concentrations. Methods: CABMILK is an observational pharmacokinetic study nested within two ongoing CAB-LA implementation studies in Malawi. A total of 100 mother-infant pairs will be enrolled: 25 receiving CAB-LA, 25 receiving oral PrEP, and 50 PrEP-naïve. Serial maternal plasma and breast milk samples will be collected to quantify cabotegravir concentrations using validated LC-MS/MS assays and to estimate milk-to-plasma ratios and infant exposure. Infant safety monitoring will include clinical assessments, growth measurements, and developmental evaluation using the Caregiver Reported Early Development Index (CREDI) Short Form over 8 months of follow-up. Expected findings: This study will provide empirical data on cabotegravir transfer into breast milk, quantify infant exposure, and generate early comparative safety data. Conclusions: CABMILK will generate essential evidence to guide the safe implementation of CAB-LA among breastfeeding women and inform HIV prevention policy in high-burden settings.

Indexed as

BreastfeedingMaternal-Child HealthPharmaco-epidemiologyPharmacokineticsPopulation HealthPrEP/HIV preventionPublic and Global Health

Identifiers

PMID42359117
PMCPMC13291744

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.