Early infant feeding patterns and HIV-free survival: findings from the Kesho-Bora trial (Burkina Faso, Kenya, South Africa)
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. From June 2005 to August 2008, HIV-infected pregnant women were counseled regarding infant feeding...
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| Veröffentlicht in: | The Pediatric infectious disease journal 2015-02, Vol.34 (2), p.168-174 |
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| container_title | The Pediatric infectious disease journal |
| container_volume | 34 |
| creator | Cournil, Amandine Van de Perre, Philippe Cames, Cécile de Vincenzi, Isabelle Read, Jennifer S Luchters, Stanley Meda, Nicolas Naidu, Kevi Newell, Marie-Louise Bork, Kirsten |
| description | 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.
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 |
| doi_str_mv | 10.1097/INF.0000000000000512 |
| format | Article |
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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).
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.
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.</description><identifier>ISSN: 0891-3668</identifier><identifier>EISSN: 1532-0987</identifier><identifier>DOI: 10.1097/INF.0000000000000512</identifier><identifier>PMID: 25741969</identifier><language>eng</language><publisher>United States</publisher><subject>Africa ; Anti-HIV Agents - administration & dosage ; Chemoprevention - methods ; Feeding Behavior ; Female ; HIV Infections - drug therapy ; HIV Infections - prevention & control ; HIV Infections - transmission ; Humans ; Infant ; Infant, Newborn ; Infectious Disease Transmission, Vertical - prevention & control ; Pre-Exposure Prophylaxis - methods ; Pregnancy ; Survival Analysis</subject><ispartof>The Pediatric infectious disease journal, 2015-02, Vol.34 (2), p.168-174</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-cad673212c7eb32880ef78f9bd4670408996c973f63b429e5f8af496627c77f43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25741969$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cournil, Amandine</creatorcontrib><creatorcontrib>Van de Perre, Philippe</creatorcontrib><creatorcontrib>Cames, Cécile</creatorcontrib><creatorcontrib>de Vincenzi, Isabelle</creatorcontrib><creatorcontrib>Read, Jennifer S</creatorcontrib><creatorcontrib>Luchters, Stanley</creatorcontrib><creatorcontrib>Meda, Nicolas</creatorcontrib><creatorcontrib>Naidu, Kevi</creatorcontrib><creatorcontrib>Newell, Marie-Louise</creatorcontrib><creatorcontrib>Bork, Kirsten</creatorcontrib><creatorcontrib>Kesho Bora Study Group</creatorcontrib><title>Early infant feeding patterns and HIV-free survival: findings from the Kesho-Bora trial (Burkina Faso, Kenya, South Africa)</title><title>The Pediatric infectious disease journal</title><addtitle>Pediatr Infect Dis J</addtitle><description>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.
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).
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.
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.</description><subject>Africa</subject><subject>Anti-HIV Agents - administration & dosage</subject><subject>Chemoprevention - methods</subject><subject>Feeding Behavior</subject><subject>Female</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - prevention & control</subject><subject>HIV Infections - transmission</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infectious Disease Transmission, Vertical - prevention & control</subject><subject>Pre-Exposure Prophylaxis - methods</subject><subject>Pregnancy</subject><subject>Survival Analysis</subject><issn>0891-3668</issn><issn>1532-0987</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkF1PwjAUhhujEUT_gTG9xIRhP7Z29Q4ICJHohR-3S7e1Ut06bDcS4p93BDTGc3MuzvOek_MAcInRECPBbxYPsyH6WxEmR6CLI0oCJGJ-DLooFjigjMUdcOb9e8vQEKNT0CERD7Fgogu-ptIVW2islraGWqnc2De4lnWtnPVQ2hzOF6-BdkpB37iN2cjiFmpjd5yH2lUlrFcK3iu_qoJx5SSsnZEF7I8b92GshDPpq0E7t1s5gE9VU6_gSDuTyetzcKJl4dXFoffAy2z6PJkHy8e7xWS0DDISsTrIZM44JZhkXKWUxDFSmsdapHnIOArbJwXLBKea0TQkQkU6ljoUjBGeca5D2gP9_d61qz4b5eukND5TRSGtqhqfYMYwJQwz0aLhHs1c5b1TOlk7U0q3TTBKdtqTVnvyX3sbuzpcaNJS5b-hH8_0G0kEfFQ</recordid><startdate>20150201</startdate><enddate>20150201</enddate><creator>Cournil, Amandine</creator><creator>Van de Perre, Philippe</creator><creator>Cames, Cécile</creator><creator>de Vincenzi, Isabelle</creator><creator>Read, Jennifer S</creator><creator>Luchters, Stanley</creator><creator>Meda, Nicolas</creator><creator>Naidu, Kevi</creator><creator>Newell, Marie-Louise</creator><creator>Bork, Kirsten</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150201</creationdate><title>Early infant feeding patterns and HIV-free survival: findings from the Kesho-Bora trial (Burkina Faso, Kenya, South Africa)</title><author>Cournil, Amandine ; Van de Perre, Philippe ; Cames, Cécile ; de Vincenzi, Isabelle ; Read, Jennifer S ; Luchters, Stanley ; Meda, Nicolas ; Naidu, Kevi ; Newell, Marie-Louise ; Bork, Kirsten</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-cad673212c7eb32880ef78f9bd4670408996c973f63b429e5f8af496627c77f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Africa</topic><topic>Anti-HIV Agents - administration & dosage</topic><topic>Chemoprevention - methods</topic><topic>Feeding Behavior</topic><topic>Female</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - prevention & control</topic><topic>HIV Infections - transmission</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infectious Disease Transmission, Vertical - prevention & control</topic><topic>Pre-Exposure Prophylaxis - methods</topic><topic>Pregnancy</topic><topic>Survival Analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cournil, Amandine</creatorcontrib><creatorcontrib>Van de Perre, Philippe</creatorcontrib><creatorcontrib>Cames, Cécile</creatorcontrib><creatorcontrib>de Vincenzi, Isabelle</creatorcontrib><creatorcontrib>Read, Jennifer S</creatorcontrib><creatorcontrib>Luchters, Stanley</creatorcontrib><creatorcontrib>Meda, Nicolas</creatorcontrib><creatorcontrib>Naidu, Kevi</creatorcontrib><creatorcontrib>Newell, Marie-Louise</creatorcontrib><creatorcontrib>Bork, Kirsten</creatorcontrib><creatorcontrib>Kesho Bora Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Pediatric infectious disease journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cournil, Amandine</au><au>Van de Perre, Philippe</au><au>Cames, Cécile</au><au>de Vincenzi, Isabelle</au><au>Read, Jennifer S</au><au>Luchters, Stanley</au><au>Meda, Nicolas</au><au>Naidu, Kevi</au><au>Newell, Marie-Louise</au><au>Bork, Kirsten</au><aucorp>Kesho Bora Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early infant feeding patterns and HIV-free survival: findings from the Kesho-Bora trial (Burkina Faso, Kenya, South Africa)</atitle><jtitle>The Pediatric infectious disease journal</jtitle><addtitle>Pediatr Infect Dis J</addtitle><date>2015-02-01</date><risdate>2015</risdate><volume>34</volume><issue>2</issue><spage>168</spage><epage>174</epage><pages>168-174</pages><issn>0891-3668</issn><eissn>1532-0987</eissn><abstract>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.
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).
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.
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.</abstract><cop>United States</cop><pmid>25741969</pmid><doi>10.1097/INF.0000000000000512</doi><tpages>7</tpages></addata></record> |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Africa Anti-HIV Agents - administration & dosage Chemoprevention - methods Feeding Behavior Female HIV Infections - drug therapy HIV Infections - prevention & control HIV Infections - transmission Humans Infant Infant, Newborn Infectious Disease Transmission, Vertical - prevention & control Pre-Exposure Prophylaxis - methods Pregnancy Survival Analysis |
| title | Early infant feeding patterns and HIV-free survival: findings from the Kesho-Bora trial (Burkina Faso, Kenya, South Africa) |
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