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Breastfeeding with maternal antiretroviral therapy or formula feeding to prevent HIV postnatal mother-to-child transmission in Rwanda.
AIDS 2009; 23(18):2415-23AIDS

Abstract

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+Show Affiliations

INT 108 ESTHER Phase 2 Project /Luxembourg (Lux-Development) in Kigali, Rwanda. alexandrapeltier@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19730349

Citation

Peltier, Cécile Alexandra, et al. "Breastfeeding With Maternal Antiretroviral Therapy or Formula Feeding to Prevent HIV Postnatal Mother-to-child Transmission in Rwanda." AIDS (London, England), vol. 23, no. 18, 2009, pp. 2415-23.
Peltier CA, Ndayisaba GF, Lepage P, et al. Breastfeeding with maternal antiretroviral therapy or formula feeding to prevent HIV postnatal mother-to-child transmission in Rwanda. AIDS. 2009;23(18):2415-23.
Peltier, C. A., Ndayisaba, G. F., Lepage, P., van Griensven, J., Leroy, V., Pharm, C. O., ... Arendt, V. (2009). Breastfeeding with maternal antiretroviral therapy or formula feeding to prevent HIV postnatal mother-to-child transmission in Rwanda. AIDS (London, England), 23(18), pp. 2415-23. doi:10.1097/QAD.0b013e32832ec20d.
Peltier CA, et al. Breastfeeding With Maternal Antiretroviral Therapy or Formula Feeding to Prevent HIV Postnatal Mother-to-child Transmission in Rwanda. AIDS. 2009 Nov 27;23(18):2415-23. PubMed PMID: 19730349.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Breastfeeding with maternal antiretroviral therapy or formula feeding to prevent HIV postnatal mother-to-child transmission in Rwanda. AU - Peltier,Cécile Alexandra, AU - Ndayisaba,Gilles François, AU - Lepage,Philippe, AU - van Griensven,Johan, AU - Leroy,Valériane, AU - Pharm,Christine Omes, AU - Ndimubanzi,Patrick Cyaga, AU - Courteille,Olivier, AU - Arendt,Vic, PY - 2009/9/5/entrez PY - 2009/9/5/pubmed PY - 2011/1/12/medline SP - 2415 EP - 23 JF - AIDS (London, England) JO - AIDS VL - 23 IS - 18 N2 - 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. SN - 1473-5571 UR - https://www.unboundmedicine.com/medline/citation/19730349/Breastfeeding_with_maternal_antiretroviral_therapy_or_formula_feeding_to_prevent_HIV_postnatal_mother_to_child_transmission_in_Rwanda_ L2 - http://Insights.ovid.com/pubmed?pmid=19730349 DB - PRIME DP - Unbound Medicine ER -