Breastfeeding by HIV-1-infected women and outcome in their infants: a cohort study from Durban, South Africa
Breastfeeding by HIV-1-infected women and outcome in their infants: a cohort study from Durban, South Africa
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DOI：
10.1097/00002030-199713000-00012
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发表时间：
1997-11-01
期刊：
影响因子：
3.8
通讯作者：
Coovadia, H
中科院分区：
文献类型：
--
作者：
Bobat, R;Moodley, D;Coovadia, H
背景资料：发展中国家的妇女在权衡通过母乳传播艾滋病毒的风险与母乳喂养的巨大好处之间面临着困难的选择。然而，尚不清楚当母亲感染艾滋病毒时，母乳喂养的好处是否相同。因此，我们研究了母乳喂养对HIV-1感染妇女的婴儿的感染、生长和死亡率的影响。方法：HIV-1阳性妇女的婴儿从出生起就被随访，每次随访时，他们都被检查，记录生长参数，并记录喂养方法、当前和中期疾病。在有喂养数据的43名艾滋病毒感染婴儿和90名非感染婴儿中，36名婴儿（27%）完全母乳喂养，76名婴儿（57%）接受混合喂养，21名婴儿（16%）仅接受配方奶粉喂养。纯母乳喂养的HIV感染率为39%，纯配方奶粉喂养的HIV感染率为24%，混合喂养的HIV感染率为32%[纯母乳喂养组和纯配方奶粉喂养组之间的相对危险度（RR），7.39 95%置信区间（CI），1.67-32.6]。纯母乳喂养持续时间为1个月、2个月和3个月时，传播率逐步增加（分别为45%、64%和75%）。在受感染的婴儿中，7名（50%）纯母乳喂养的婴儿，13名（51%）混合喂养的婴儿，没有一名婴儿仅发展为艾滋病;纯母乳喂养的婴儿比混合喂养的婴儿发展为艾滋病的速度更慢（平均年龄，7.5个月对5.0个月，P = 0.2242）。死亡率（仅发生在受感染的婴儿中）在纯母乳喂养的婴儿中为19%，在混合喂养的婴儿中为13%，在纯配方奶粉喂养的婴儿中为0%。三组感染和未感染infants.Conclusions：纯母乳喂养的艾滋病毒感染的妇女似乎并不能保护他们的婴儿免受常见的儿童疾病和茁壮成长失败，也没有显着延迟进展为艾滋病。不同喂养组的死亡率差异趋势的含义尚不确定，需要进一步调查。
Background: Women in developing countries have the difficult choice of balancing the risk of transmitting HIV through breast milk against the substantial benefits of breastfeeding. It is not known, however, whether the benefits of breastfeeding are the same when the mother is HIV-infected. Therefore, we examined the impact of breastfeeding on infections, growth and mortality in the infants of HIV-1-infected women.Methods: Infants of HIV-l-positive women were followed from birth and at each visit they were examined, growth parameters were recorded and notes were made of feeding method, and of current and interim illnesses.Results: Of the 43 HIV-infected and 90 non-infected infants for whom feeding data were available, 36 infants (27%) were exclusively breastfed, 76 (57%) received mixed feeding, and 21 (16%) received formula only. The HIV transmission rate was 39% in those exclusively breastfed, 24% in those fed exclusively on formula and 32% in those receiving mixed feeding [relative risk (RR), 7.39 95% confidence interval (CI), 1.67-32.6 between the exclusive bt east and formula only groups]. There was a stepwise increase in the transmission rats with duration of exclusive breastfeeding of 1, 2, and 3 months (45%, 64%, and 75%, respectively). Of the infected infants, seven (50%) exclusively breastfed, 13 (51%) of those on mixed feeds and none on formula only developed AIDS; exclusively breastfed infants had a slower rate of progression to AIDS (mean age, 7.5 months versus 5.0 months, P = 0.2242) than those on mixed feeds. Mortality (which occurred in the infected infants only) was 19% in the exclusively breastfed infants; 13% in those on mixed feeds and 0% in those exclusively formula-fed. The frequency of failure to thrive and episodes of diarrhoea and pneumonia were not significantly different between the three groups in both the infected and non-infected infants.Conclusions: Exclusive breastfeeding by HIV-infected women does not appear to protect their infants against common childhood illnesses and failure to thrive, nor does it significantly delay progression to AIDS. The implication of the trend towards differential mortality rates according ro feeding groups is uncertain and requires further investigation.