|
|
|
|
| LEADER |
02455 am a22002173u 4500 |
| 001 |
379612 |
| 042 |
|
|
|a dc
|
| 100 |
1 |
0 |
|a Cournil, A.
|e author
|
| 700 |
1 |
0 |
|a van de Perre, P.
|e author
|
| 700 |
1 |
0 |
|a Cames, C.
|e author
|
| 700 |
1 |
0 |
|a de Vincenzi, I.
|e author
|
| 700 |
1 |
0 |
|a Read, J.S.
|e author
|
| 700 |
1 |
0 |
|a Luchters, S.
|e author
|
| 700 |
1 |
0 |
|a Meda, N.
|e author
|
| 700 |
1 |
0 |
|a Naidu, K.
|e author
|
| 700 |
1 |
0 |
|a Newell, M.L.
|e author
|
| 245 |
0 |
0 |
|a Early infant feeding patterns and HIV-free survival
|
| 260 |
|
|
|c 2015-02.
|
| 856 |
|
|
|z Get fulltext
|u https://eprints.soton.ac.uk/379612/1/Early%2520Infant%2520feeding%2520and%2520child%2520survival%2520Cournil_PIDJ_2015.pdf
|
| 520 |
|
|
|a Objective: to investigate the association between feeding patterns and HIV-free survival in children born to HIV-infected mothers and to clarify whether antiretroviral (ARV) prophylaxis modifies the association. Methods: from June 2005 to August 2008, HIV-infected pregnant women were counseled regarding infant feeding options, and randomly assigned to triple-ARV prophylaxis (triple ARV) until breastfeeding cessation (BFC) before age 6 months or antenatal zidovudine with single-dose nevirapine (short-course ARV). Eighteen-month HIV-free survival of infants HIV-negative at 2 weeks of age was assessed by feeding patterns (replacement feeding from birth, BFC <3 months, BFC ?3 months). Results: of the 753 infants alive and HIV-negative at 2 weeks, 28 acquired infection and 47 died by 18 months. Overall HIV-free survival at 18 months was 0.91 [95% confidence interval (CI): 0.88-0.93]. In the short-course ARV arm, HIV-free survival (0.88; CI: 0.84-0.91) did not differ by feeding patterns. In the triple ARV arm, overall HIV-free survival was 0.93 (CI: 0.90-0.95) and BFC <3 months was associated with lower HIV-free survival than BFC ?3 months (adjusted hazard ratio: 0.36; CI: 0.15-0.83) and replacement feeding (adjusted hazard ratio: 0.20; CI: 0.04-0.94). In the triple ARV arm, 4 of 9 transmissions occurred after reported BFC (and 5 of 19 in the short-course arm), indicating that some women continued breastfeeding after interruption of ARV prophylaxis. Conclusions: in resource-constrained settings, early weaning has previously been associated with higher infant mortality. We show that, even with maternal triple-ARV prophylaxis during breastfeeding, early weaning remains associated with lower HIV-free survival, driven in particular by increased mortality
|
| 655 |
7 |
|
|a Article
|
