Advanced search
1 file | 420.05 KB Add to list

Early infant feeding patterns and HIV-free survival: findings from the Kesho-Bora Trial (Burkina Faso, Kenya, South Africa)

Author
Organization
Abstract
Objective: 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. Methods: 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). Results: 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. Conclusions: 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.
Keywords
CELL-FREE, CLINICAL-TRIAL, UNINFECTED CHILDREN, BREAST-MILK, ZIDOVUDINE PROPHYLAXIS, PROPENSITY SCORE METHODS, RANDOMIZED CONTROLLED-TRIAL, TO-CHILD TRANSMISSION, Africa, antiretroviral therapy, breastfeeding, prevention of mother-to-child transmission, HIV-free survival, infant, ANTIRETROVIRAL THERAPY, INFECTED MOTHERS

Downloads

  • (...).pdf
    • full text
    • |
    • UGent only
    • |
    • PDF
    • |
    • 420.05 KB

Citation

Please use this url to cite or link to this publication:

MLA
Cournil, Amandine et al. “Early Infant Feeding Patterns and HIV-free Survival: Findings from the Kesho-Bora Trial (Burkina Faso, Kenya, South Africa).” PEDIATRIC INFECTIOUS DISEASE JOURNAL 34.2 (2015): 168–174. Print.
APA
Cournil, A., Van de Perre, P., Cames, C., de Vincenzi, I., Read, J. S., Lüchters, S., Meda, N., et al. (2015). Early infant feeding patterns and HIV-free survival: findings from the Kesho-Bora Trial (Burkina Faso, Kenya, South Africa). PEDIATRIC INFECTIOUS DISEASE JOURNAL, 34(2), 168–174.
Chicago author-date
Cournil, Amandine, Philippe Van de Perre, Cécile Cames, Isabelle de Vincenzi, Jennifer S Read, Stanley Lüchters, Nicolas Meda, et al. 2015. “Early Infant Feeding Patterns and HIV-free Survival: Findings from the Kesho-Bora Trial (Burkina Faso, Kenya, South Africa).” Pediatric Infectious Disease Journal 34 (2): 168–174.
Chicago author-date (all authors)
Cournil, Amandine, Philippe Van de Perre, Cécile Cames, Isabelle de Vincenzi, Jennifer S Read, Stanley Lüchters, Nicolas Meda, Kevi Naidu, Marie-Louise Newell, Kirsten Bork, the Kesho Bora Study group, and Marleen Temmerman. 2015. “Early Infant Feeding Patterns and HIV-free Survival: Findings from the Kesho-Bora Trial (Burkina Faso, Kenya, South Africa).” Pediatric Infectious Disease Journal 34 (2): 168–174.
Vancouver
1.
Cournil A, Van de Perre P, Cames C, de Vincenzi I, Read JS, Lüchters S, et al. Early infant feeding patterns and HIV-free survival: findings from the Kesho-Bora Trial (Burkina Faso, Kenya, South Africa). PEDIATRIC INFECTIOUS DISEASE JOURNAL. 2015;34(2):168–74.
IEEE
[1]
A. Cournil et al., “Early infant feeding patterns and HIV-free survival: findings from the Kesho-Bora Trial (Burkina Faso, Kenya, South Africa),” PEDIATRIC INFECTIOUS DISEASE JOURNAL, vol. 34, no. 2, pp. 168–174, 2015.
@article{7021483,
  abstract     = {Objective: 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. 
Methods: 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). 
Results: 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. 
Conclusions: 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.},
  author       = {Cournil, Amandine and Van de Perre, Philippe and Cames, Cécile and de Vincenzi, Isabelle and Read, Jennifer S and Lüchters, Stanley and Meda, Nicolas and Naidu, Kevi and Newell, Marie-Louise and Bork, Kirsten and Kesho Bora Study group, the and Temmerman, Marleen},
  issn         = {0891-3668},
  journal      = {PEDIATRIC INFECTIOUS DISEASE JOURNAL},
  keywords     = {CELL-FREE,CLINICAL-TRIAL,UNINFECTED CHILDREN,BREAST-MILK,ZIDOVUDINE PROPHYLAXIS,PROPENSITY SCORE METHODS,RANDOMIZED CONTROLLED-TRIAL,TO-CHILD TRANSMISSION,Africa,antiretroviral therapy,breastfeeding,prevention of mother-to-child transmission,HIV-free survival,infant,ANTIRETROVIRAL THERAPY,INFECTED MOTHERS},
  language     = {eng},
  number       = {2},
  pages        = {168--174},
  title        = {Early infant feeding patterns and HIV-free survival: findings from the Kesho-Bora Trial (Burkina Faso, Kenya, South Africa)},
  url          = {http://dx.doi.org/10.1097/INF.0000000000000512},
  volume       = {34},
  year         = {2015},
}

Altmetric
View in Altmetric
Web of Science
Times cited: