Increased infant human immunodeficiency virus-type one free survival at one year of age in sub-saharan Africa with maternal use of highly active antiretroviral therapy during breast-feeding.Pediatr Infect Dis J 2009; 28(6):483-7PI
Abstract
BACKGROUND
Reduction of HIV-1 breast-feeding transmission remains a challenge for prevention of pediatric infections in Sub-Saharan Africa. Provision of formula decreases transmission but often increases child mortality in this setting.
METHODS
A prospective observational cohort study of HIV-1 exposed infants of mothers receiving pre and postnatal medical care at Drug Resource Enhancement Against AIDS and Malnutrition centers in Mozambique was conducted. Live-born infants of HIV-1-infected women receiving medical care were enrolled. HIV-1 testing was performed at 1, 6, and 12 months of age using branched DNA. Mothers were counseled to breast-feed exclusively for 6 months and were provided HAART antenatally and postnatally for the first 6 months. Women with CD4 cell counts less than 350/cmm at baseline continued HAART indefinitely.
RESULTS
Of 341 infants followed from birth, 313 mother-infant pairs (92%) completed 6 months and 283 (83%) completed 12 months of follow-up. HIV-1 diagnosis was ascertained in 287 infants (84%) including 4 who died. There were 8 cases of HIV-1 transmission: 4 of 341 (1.2%) at 1 month, 2 of 313 (0.6%) at 6 months, and 2 of 276 (0.7%) at 12 months (cumulative rate: 2.8%). Two mothers (0.6%) and 11 infants (3.2%) died. Maternal and infant mortality rates were 587 of 100,000 and 33 of 1000, while country rates are 1000 of 100,000 and 101 of 1000. HIV risk reduction was 93% and HIV-free survival at 12 months was 94%.
CONCLUSIONS
Late postnatal transmission of HIV-1 is significantly decreased by maternal use of HAART with high infant survival rates up to 12 months of age.
MeSH
AdultAfrica South of the SaharaAnti-HIV AgentsAntiretroviral Therapy, Highly ActiveBreast FeedingChi-Square DistributionDisease-Free SurvivalFemaleHIV InfectionsHIV-1HumansInfantInfant, NewbornInfectious Disease Transmission, VerticalKaplan-Meier EstimatePregnancyPregnancy Complications, InfectiousProportional Hazards ModelsViral Load
Pub Type(s)
Journal Article
Language
eng
PubMed ID
19483516
Citation
Marazzi, Maria Cristina, et al. "Increased Infant Human Immunodeficiency Virus-type One Free Survival at One Year of Age in Sub-saharan Africa With Maternal Use of Highly Active Antiretroviral Therapy During Breast-feeding." The Pediatric Infectious Disease Journal, vol. 28, no. 6, 2009, pp. 483-7.
Marazzi MC, Nielsen-Saines K, Buonomo E, et al. Increased infant human immunodeficiency virus-type one free survival at one year of age in sub-saharan Africa with maternal use of highly active antiretroviral therapy during breast-feeding. Pediatr Infect Dis J. 2009;28(6):483-7.
Marazzi, M. C., Nielsen-Saines, K., Buonomo, E., Scarcella, P., Germano, P., Majid, N. A., ... Palombi, L. (2009). Increased infant human immunodeficiency virus-type one free survival at one year of age in sub-saharan Africa with maternal use of highly active antiretroviral therapy during breast-feeding. The Pediatric Infectious Disease Journal, 28(6), pp. 483-7. doi:10.1097/INF.0b013e3181950c56.
Marazzi MC, et al. Increased Infant Human Immunodeficiency Virus-type One Free Survival at One Year of Age in Sub-saharan Africa With Maternal Use of Highly Active Antiretroviral Therapy During Breast-feeding. Pediatr Infect Dis J. 2009;28(6):483-7. PubMed PMID: 19483516.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR
T1 - Increased infant human immunodeficiency virus-type one free survival at one year of age in sub-saharan Africa with maternal use of highly active antiretroviral therapy during breast-feeding.
AU - Marazzi,Maria Cristina,
AU - Nielsen-Saines,Karin,
AU - Buonomo,Ersilia,
AU - Scarcella,Paola,
AU - Germano,Paola,
AU - Majid,Nuria Abdul,
AU - Zimba,Ines,
AU - Ceffa,Susanna,
AU - Palombi,Leonardo,
PY - 2009/6/2/entrez
PY - 2009/6/2/pubmed
PY - 2009/9/1/medline
SP - 483
EP - 7
JF - The Pediatric infectious disease journal
JO - Pediatr. Infect. Dis. J.
VL - 28
IS - 6
N2 - BACKGROUND: Reduction of HIV-1 breast-feeding transmission remains a challenge for prevention of pediatric infections in Sub-Saharan Africa. Provision of formula decreases transmission but often increases child mortality in this setting. METHODS: A prospective observational cohort study of HIV-1 exposed infants of mothers receiving pre and postnatal medical care at Drug Resource Enhancement Against AIDS and Malnutrition centers in Mozambique was conducted. Live-born infants of HIV-1-infected women receiving medical care were enrolled. HIV-1 testing was performed at 1, 6, and 12 months of age using branched DNA. Mothers were counseled to breast-feed exclusively for 6 months and were provided HAART antenatally and postnatally for the first 6 months. Women with CD4 cell counts less than 350/cmm at baseline continued HAART indefinitely. RESULTS: Of 341 infants followed from birth, 313 mother-infant pairs (92%) completed 6 months and 283 (83%) completed 12 months of follow-up. HIV-1 diagnosis was ascertained in 287 infants (84%) including 4 who died. There were 8 cases of HIV-1 transmission: 4 of 341 (1.2%) at 1 month, 2 of 313 (0.6%) at 6 months, and 2 of 276 (0.7%) at 12 months (cumulative rate: 2.8%). Two mothers (0.6%) and 11 infants (3.2%) died. Maternal and infant mortality rates were 587 of 100,000 and 33 of 1000, while country rates are 1000 of 100,000 and 101 of 1000. HIV risk reduction was 93% and HIV-free survival at 12 months was 94%. CONCLUSIONS: Late postnatal transmission of HIV-1 is significantly decreased by maternal use of HAART with high infant survival rates up to 12 months of age.
SN - 0891-3668
UR - https://www.unboundmedicine.com/medline/citation/19483516/Increased_infant_human_immunodeficiency_virus_type_one_free_survival_at_one_year_of_age_in_sub_saharan_Africa_with_maternal_use_of_highly_active_antiretroviral_therapy_during_breast_feeding_
L2 - http://dx.doi.org/10.1097/INF.0b013e3181950c56
DB - PRIME
DP - Unbound Medicine
ER -
