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Postpartum weight change among HIV-infected mothers by antiretroviral prophylaxis and infant feeding modality in a research setting

(2014) AIDS. 28(1). p.85-94
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Organization
Abstract
Objective: To assess the relationship between infant feeding, triple-antiretroviral prophylaxis and weight from 2 weeks (baseline) to 6 months postpartum among HIV-infected mothers in a mother-to-child transmission (MTCT) of HIV-prevention trial in five sub-Saharan African sites. Methods: HIV-infected pregnant women with CD4(+) cell counts of 200-500cells/l were counselled to choose breastfeeding to 6 months or replacement feeding from delivery. They were randomized to receive perinatal zidovudine and single-dose nevirapine or triple-antiretroviral MTCT prophylaxis until breastfeeding cessation. Mixed-effect linear models were used to compare maternal weight trajectories over time by infant feeding mode. Antiretroviral prophylaxis and BMI at baseline were examined as potential effect modifiers. Results: Among 797 mothers, 620 (78%) initiated breastfeeding. Wasting (BMI <18.5) was rare at baseline (2%), whereas overweight/obesity (BMI25) was common (40%). In the model including all women, breastfeeding was not associated with weight loss up to 6 months, irrespective of baseline BMI and antiretroviral prophylaxis. Triple-antiretroviral prophylaxis was associated with weight gain among replacement-feeding mothers with baseline BMI at least 25 (+0.54kg/month; P<0.0001). In the model including breastfeeding mothers only, triple-antiretroviral prophylaxis was associated with weight gain among mothers with baseline BMI at least 25 who ceased breastfeeding before 3 months postpartum (+0.33kg/month; P=0.03). Conclusion: The results suggest that breastfeeding up to 6 months postpartum is not detrimental for postpartum weight among well nourished HIV-infected mothers at intermediate-disease stage. In the absence of breastfeeding or after weaning, triple-antiretroviral prophylaxis is associated with weight gain among women with high BMI, even after cessation of prophylaxis.
Keywords
DOSE NEVIRAPINE PROPHYLAXIS, BODY-MASS INDEX, TO-CHILD TRANSMISSION, RANDOMIZED CONTROLLED-TRIAL, overweight, HIV infection, breastfeeding, body weight change, DISEASE PROGRESSION, KESHO BORA, AFRICAN WOMEN, PERCEPTIONS, THERAPY, LACTATION, Africa, antiretroviral prophylaxis

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Citation

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MLA
Cames, Cecile, Amandine Cournil, Isabelle de Vincenzi, et al. “Postpartum Weight Change Among HIV-infected Mothers by Antiretroviral Prophylaxis and Infant Feeding Modality in a Research Setting.” AIDS 28.1 (2014): 85–94. Print.
APA
Cames, C., Cournil, A., de Vincenzi, I., Gaillard, P., Meda, N., Lüchters, S., Nduati, R., et al. (2014). Postpartum weight change among HIV-infected mothers by antiretroviral prophylaxis and infant feeding modality in a research setting. AIDS, 28(1), 85–94.
Chicago author-date
Cames, Cecile, Amandine Cournil, Isabelle de Vincenzi, Philippe Gaillard, Nicolas Meda, Stanley Lüchters, Ruth Nduati, et al. 2014. “Postpartum Weight Change Among HIV-infected Mothers by Antiretroviral Prophylaxis and Infant Feeding Modality in a Research Setting.” Aids 28 (1): 85–94.
Chicago author-date (all authors)
Cames, Cecile, Amandine Cournil, Isabelle de Vincenzi, Philippe Gaillard, Nicolas Meda, Stanley Lüchters, Ruth Nduati, Kevindra Naidu, Marie-Louise Newell, Jennifer S Read, and Kirsten Bork. 2014. “Postpartum Weight Change Among HIV-infected Mothers by Antiretroviral Prophylaxis and Infant Feeding Modality in a Research Setting.” Aids 28 (1): 85–94.
Vancouver
1.
Cames C, Cournil A, de Vincenzi I, Gaillard P, Meda N, Lüchters S, et al. Postpartum weight change among HIV-infected mothers by antiretroviral prophylaxis and infant feeding modality in a research setting. AIDS. 2014;28(1):85–94.
IEEE
[1]
C. Cames et al., “Postpartum weight change among HIV-infected mothers by antiretroviral prophylaxis and infant feeding modality in a research setting,” AIDS, vol. 28, no. 1, pp. 85–94, 2014.
@article{5667248,
  abstract     = {Objective: To assess the relationship between infant feeding, triple-antiretroviral prophylaxis and weight from 2 weeks (baseline) to 6 months postpartum among HIV-infected mothers in a mother-to-child transmission (MTCT) of HIV-prevention trial in five sub-Saharan African sites.
Methods: HIV-infected pregnant women with CD4(+) cell counts of 200-500cells/l were counselled to choose breastfeeding to 6 months or replacement feeding from delivery. They were randomized to receive perinatal zidovudine and single-dose nevirapine or triple-antiretroviral MTCT prophylaxis until breastfeeding cessation. Mixed-effect linear models were used to compare maternal weight trajectories over time by infant feeding mode. Antiretroviral prophylaxis and BMI at baseline were examined as potential effect modifiers.
Results: Among 797 mothers, 620 (78%) initiated breastfeeding. Wasting (BMI <18.5) was rare at baseline (2%), whereas overweight/obesity (BMI25) was common (40%). In the model including all women, breastfeeding was not associated with weight loss up to 6 months, irrespective of baseline BMI and antiretroviral prophylaxis. Triple-antiretroviral prophylaxis was associated with weight gain among replacement-feeding mothers with baseline BMI at least 25 (+0.54kg/month; P<0.0001). In the model including breastfeeding mothers only, triple-antiretroviral prophylaxis was associated with weight gain among mothers with baseline BMI at least 25 who ceased breastfeeding before 3 months postpartum (+0.33kg/month; P=0.03).
Conclusion: The results suggest that breastfeeding up to 6 months postpartum is not detrimental for postpartum weight among well nourished HIV-infected mothers at intermediate-disease stage. In the absence of breastfeeding or after weaning, triple-antiretroviral prophylaxis is associated with weight gain among women with high BMI, even after cessation of prophylaxis.},
  author       = {Cames, Cecile and Cournil, Amandine and de Vincenzi, Isabelle and Gaillard, Philippe and Meda, Nicolas and Lüchters, Stanley and Nduati, Ruth and Naidu, Kevindra and Newell, Marie-Louise and Read, Jennifer S and Bork, Kirsten},
  issn         = {0269-9370},
  journal      = {AIDS},
  keywords     = {DOSE NEVIRAPINE PROPHYLAXIS,BODY-MASS INDEX,TO-CHILD TRANSMISSION,RANDOMIZED CONTROLLED-TRIAL,overweight,HIV infection,breastfeeding,body weight change,DISEASE PROGRESSION,KESHO BORA,AFRICAN WOMEN,PERCEPTIONS,THERAPY,LACTATION,Africa,antiretroviral prophylaxis},
  language     = {eng},
  number       = {1},
  pages        = {85--94},
  title        = {Postpartum weight change among HIV-infected mothers by antiretroviral prophylaxis and infant feeding modality in a research setting},
  url          = {http://dx.doi.org/10.1097/01.aids.0000433243.24481.c3},
  volume       = {28},
  year         = {2014},
}

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