The observation that mother-to-child transmission of HIV-1 can occur through breastfeeding has resulted in policies that recommend avoidance of breastfeeding by HIV-1-infected women in the developed world and under specific circumstances in developing countries.
WE compared transmission rates in exclusively breastfed, mixed-fed and formula-fed (never breastfed) infants to assess whether the pattern of breastfeeding is a critical determinant of early mother-to-child transmission of HIV-1.
Methods We prospectively assessed infant-feeding practices of 549 HIV-1 infected women who were part of a vitamin A intervention trial in Durban, South Africa.
The proportions of HIV-infected infants at 3-months (estimated by use of Kaplan-Meier life tables) were compared in the three different feeding groups.
HIV-infection was defined by a positive RNA-PCR test.
At 3 months, 18.8% (95% Cl 12.6-24.9) of 156 never-breastfed children were estimated to be HIV-1 infected compared with 21.3% (17.2-25.5) of 393 breastfed childre (p=0.5).
The estimated proportion (Kaplan-Meier) of infants HIV-1 infected by 3 mths was significantly lower for those exclusively breastfed to 3 mths than in those who received mixed feeding before 3 mths (14.6% [7.7-21.4] vs 24.1% [19.0-29.2], p=0.03).
After adjustment for potential confounders (...) exclusive breastfeeding carried a significantly lower risk of HIV-1 transmission than mixed feeding (...) and a similar risk to no breastfeeding (...).
Mots-clés Pascal : Allaitement, Mère, Rétinol, Nourrisson, Virus immunodéficience humaine, Afrique australe
Mots-clés Pascal anglais : Breast feeding, Mother, Retinol, Infant, Human immunodeficiency virus, Southern Africa
Notice produite par :
ENSP - Ecole nationale de la santé publique (devenue EHESP)
Cote : 99/08 V
Code Inist : 002B30A11. Création : 22/03/2000.