Document Detail


Early exclusive breastfeeding reduces the risk of postnatal HIV-1 transmission and increases HIV-free survival.
MedLine Citation:
PMID:  15821396     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The promotion of exclusive breastfeeding (EBF) to reduce the postnatal transmission (PNT) of HIV is based on limited data. In the context of a trial of postpartum vitamin A supplementation, we provided education and counseling about infant feeding and HIV, prospectively collected information on infant feeding practices, and measured associated infant infections and deaths. DESIGN AND METHODS: A total of 14 110 mother-newborn pairs were enrolled, randomly assigned to vitamin A treatment group after delivery, and followed for 2 years. At baseline, 6 weeks and 3 months, mothers were asked whether they were still breastfeeding, and whether any of 22 liquids or foods had been given to the infant. Breastfed infants were classified as exclusive, predominant, or mixed breastfed. RESULTS: A total of 4495 mothers tested HIV positive at baseline; 2060 of their babies were alive, polymerase chain reaction negative at 6 weeks, and provided complete feeding information. All infants initiated breastfeeding. Overall PNT (defined by a positive HIV test after the 6-week negative test) was 12.1%, 68.2% of which occurred after 6 months. Compared with EBF, early mixed breastfeeding was associated with a 4.03 (95% CI 0.98, 16.61), 3.79 (95% CI 1.40-10.29), and 2.60 (95% CI 1.21-5.55) greater risk of PNT at 6, 12, and 18 months, respectively. Predominant breastfeeding was associated with a 2.63 (95% CI 0.59-11.67), 2.69 (95% CI 0.95-7.63) and 1.61 (95% CI 0.72-3.64) trend towards greater PNT risk at 6, 12, and 18 months, compared with EBF. CONCLUSION: EBF may substantially reduce breastfeeding-associated HIV transmission.
Authors:
Peter J Iliff; Ellen G Piwoz; Naume V Tavengwa; Clare D Zunguza; Edmore T Marinda; Kusum J Nathoo; Lawrence H Moulton; Brian J Ward; Jean H Humphrey;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  AIDS (London, England)     Volume:  19     ISSN:  0269-9370     ISO Abbreviation:  AIDS     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-04-11     Completed Date:  2005-09-20     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8710219     Medline TA:  AIDS     Country:  England    
Other Details:
Languages:  eng     Pagination:  699-708     Citation Subset:  IM; X    
Affiliation:
ZVITAMBO Project, Borrowdale, Harare, Zimbabwe.
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MeSH Terms
Descriptor/Qualifier:
AIDS Serodiagnosis
Acquired Immunodeficiency Syndrome / prevention & control,  transmission*
Adult
Breast Feeding*
Developing Countries*
Disease-Free Survival
Female
Follow-Up Studies
HIV-1*
Humans
Infant
Infant, Newborn
Infectious Disease Transmission, Vertical / prevention & control
Milk, Human
Proportional Hazards Models
Risk Assessment
Vitamin A / therapeutic use
Weaning
Zimbabwe
Chemical
Reg. No./Substance:
11103-57-4/Vitamin A

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


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