Many relevant issues arose within this study;
however, it was not our aim to address these issues in the present
article. All the points raised had been discussed by our team;
however, for the sake of brevity and compactness of the manuscript,
they had not been elaborated on. We have also highlighted some of the
shortcomings of the present study under discussion:
1. This study did not aim to compare transmission
rates in intervention vs. non-intervention groups. We have
nevertheless mentioned in passing that in those, whom no
intervention was offered, transmission rates were significantly
2. The group we analyzed and followed up did not
breastfeed their infants at all, in fact that (i.e., not
breastfeeding) was one of our four arms. We have clarified in text
that we have not assessed the individual beneficial effects of any
one selected strategy. We wanted to highlight the fact that
collectively these four arms/strategies were noted to be beneficial
in the population studied.
3. The point of testing beyond the grey zone is
well taken. Studies done at centers in populations that do not have
access to P24 and PCR testing should test infants beyond 18 months
of age for their infectivity. At the point of conducting this study,
P24 and PCR were not available at our center.
4. The point of cost benefit is also well made.
We have not dealt with the issue of costings of formula feeds, as
this was again not part of our aims and objectives. Nonetheless,
yes, this is a point to be taken into consideration, as is the issue
of increased risk of external infections in non-breastfed infants.
Rashid H. Merchant,
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5th Floor, 2 Mount Mary Road,
Bandra (West), Mumbai 400 050,