Early mixed feeding and breastfeeding beyond 6 months increase the risk of postnatal HIV transmission: ANRS 1201/1202 Ditrame Plus, Abidjan, Cote d'Ivoire
Early mixed feeding and breastfeeding beyond 6 months increase the risk of postnatal HIV transmission: ANRS 1201/1202 Ditrame Plus, Abidjan, Cote d'Ivoire
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DOI：
10.1016/j.ypmed.2007.11.014
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发表时间：
2008-07-01
影响因子：
5.1
通讯作者：
Leroy, Valeriane
中科院分区：
文献类型：
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作者：
Becquet, Renaud;Ekouevi, Didier K.;Leroy, Valeriane
目标。为了评估艾滋病毒在阿比让妇女中出生后传播的风险，科特迪瓦提供了长时间母乳喂养的替代方案，并评估母乳喂养模式和持续时间对这一风险的影响。2001-2003年，感染艾滋病毒的孕妇接受了围产期抗逆转录病毒预防，并接受了产前关于婴儿喂养选择的咨询：配方奶喂养或纯母乳喂养，从4个月大开始提前停止喂养。主要结果是艾滋病毒在出生后18个月内传播，定义为阴性检测后30天艾滋病毒检测呈阳性。分析母乳喂养方式(母乳+食用液、固体食物或非母乳)和持续时间(少于6个月或超过6个月)对产后传播的影响。在622名在30天或之后未感染艾滋病毒的活产婴儿中，15名是在出生后感染的，13/324名是母乳喂养的，2/298名是配方奶婴儿。母乳喂养组和配方奶粉喂养组18个月未感染HIV的概率分别为0.95[95%CI，0.92~0.97]和0.99[95%CI，0.97~1.00](P<0.05)。
Objective. To evaluate the risk of postnatal HIV transmission among women in Abidjan, Cote d'Ivoire offered alternatives to prolonged breastfeeding, and to assess the impact of the breastfeeding pattern and duration on this risk.Methods. In 2001-2003, HIV-infected pregnant women received peri-partum antiretroviral prophylaxis and were counselled antenatally regarding infant feeding options: formula feeding or exclusive breastfeeding with early cessation from 4 months of age. The primary outcome was HIV postnatal transmission by 18 months of age, defined by a positive HIV test after a negative test >= 30 days. The effect of the pattern (mixed feeding, defined as breastmilk plus food-based fluid, solid food or non-human milk) and duration (less vs. more than 6 months) of breastfeeding on postnatal transmission was assessed.Results. Of 622 live-born infants who were HIV uninfected at or after 30 days, 15 were infected postnatally, 13/324 among breastfed, and 2/298 among formula-fed infants. The 18-month probability of remaining free from HIV infection was 0.95 [95% CI, 0.92-0.97] and 0.99 [95% CI, 0.97-1.00] in the breastfeeding and formula-feeding groups respectively (p