Risk factors for early and late transmission of HIV via breast-feeding among infants born to HIV-infected women in a randomized clinical trial in Botswana

RL Shapiro, L Smeaton, S Lockman… - The Journal of …, 2009 - academic.oup.com
RL Shapiro, L Smeaton, S Lockman, I Thior, R Rossenkhan, C Wester, L Stevens, C Moffat…
The Journal of infectious diseases, 2009academic.oup.com
Risk factors for mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV)
via breast-feeding were evaluated in a randomized trial. HIV-infected women and their
infants received zidovudine as well as single-dose nevirapine or placebo. Infants were
randomized to formula-feed (FF) or breast-feed (BF) in combination with zidovudine
prophylaxis. Of 1116 at-risk infants, 6 (1.1%) in the FF group and 7 (1.3%) in the BF group
were infected between birth and 1 month (P=. 99). Maternal receipt of nevirapine did not …
Abstract
Risk factors for mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) via breast-feeding were evaluated in a randomized trial. HIV-infected women and their infants received zidovudine as well as single-dose nevirapine or placebo. Infants were randomized to formula-feed (FF) or breast-feed (BF) in combination with zidovudine prophylaxis. Of 1116 at-risk infants, 6 (1.1%) in the FF group and 7 (1.3%) in the BF group were infected between birth and 1 month (P = .99). Maternal receipt of nevirapine did not predict early MTCT in the BF group (P = .45). Of 547 infants in the BF group at risk for late MTCT, 24 (4.4%) were infected. Maternal HIV-1 RNA levels in plasma (P<.001) and breast milk (P<.001) predicted late MTCT. These findings support the safety of 1 month of breast-feeding in combination with maternal and infant antiretroviral prophylaxis.
Trial registration. ClinicalTrials.gov identifiers: NCT- 00197691 and NCT00197652.
Oxford University Press
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