Document Detail


Breastfeeding with maternal antiretroviral therapy or formula feeding to prevent HIV postnatal mother-to-child transmission in Rwanda.
MedLine Citation:
PMID:  19730349     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the 9-month HIV-free survival of children with two strategies to prevent HIV mother-to-child transmission.
DESIGN: Nonrandomized interventional cohort study.
SETTING: Four public health centres in Rwanda.
PARTICIPANTS: Between May 2005 and January 2007, all consenting HIV-infected pregnant women were included.
INTERVENTION: Women could choose the mode of feeding for their infant: breastfeeding with maternal HAART for 6 months or formula feeding. All received HAART from 28 weeks of gestation. Nine-month cumulative probabilities of HIV transmission and HIV-free survival were determined using the Kaplan-Meier method and compared using the log-rank test. Determinants were analysed using a Cox model analysis.
RESULTS: Of the 532 first-liveborn infants, 227 (43%) were breastfeeding and 305 (57%) were formula feeding. Overall, seven (1.3%) children were HIV-infected of whom six were infected in utero. Only one child in the breastfeeding group became infected between months 3 and 7, corresponding to a 9-month cumulative risk of postnatal infection of 0.5% [95% confidence interval (CI) 0.1-3.4%; P = 0.24] with breastfeeding. Nine-month cumulative mortality was 3.3% (95% CI 1.6-6.9%) in the breastfeeding arm group and 5.7% (95% CI 3.6-9.2%) for the formula feeding group (P = 0.20). HIV-free survival by 9 months was 95% (95% CI 91-97%) in the breastfeeding group and 94% (95% CI 91-96%) for the formula feeding group (P = 0.66), with no significant difference in the adjusted analysis (adjusted hazard ratio for breastfeeding: 1.2 (95% CI 0.5-2.9%).
CONCLUSION: : Maternal HAART while breastfeeding could be a promising alternative strategy in resource-limited countries.
Authors:
Cécile Alexandra Peltier; Gilles François Ndayisaba; Philippe Lepage; Johan van Griensven; Valériane Leroy; Christine Omes Pharm; Patrick Cyaga Ndimubanzi; Olivier Courteille; Vic Arendt
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  AIDS (London, England)     Volume:  23     ISSN:  1473-5571     ISO Abbreviation:  AIDS     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-12     Completed Date:  2011-01-11     Revised Date:  2013-05-31    
Medline Journal Info:
Nlm Unique ID:  8710219     Medline TA:  AIDS     Country:  England    
Other Details:
Languages:  eng     Pagination:  2415-23     Citation Subset:  IM; X    
Affiliation:
INT 108 ESTHER Phase 2 Project /Luxembourg (Lux-Development) in Kigali, Rwanda. alexandrapeltier@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Antiretroviral Therapy, Highly Active / methods*
Breast Feeding*
Cohort Studies
Female
HIV Infections / drug therapy,  epidemiology,  transmission*
HIV-1*
Humans
Infant
Infant Formula / administration & dosage*
Infant, Newborn
Infectious Disease Transmission, Vertical / prevention & control*
Post-Exposure Prophylaxis / methods
Pregnancy
Pregnancy Complications, Infectious / drug therapy,  epidemiology
Rwanda / epidemiology
Survival Analysis
Comments/Corrections
Comment In:
AIDS. 2009 Nov 27;23(18):2473-7   [PMID:  19838097 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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