Passed to me on another list:
Iliff PJ, Piwoz EG, Tavengwa NV, Zunguza CD, Marinda ET, Nathoo KJ, Moulton
LH, Ward BJ, Humphrey JH.
Early exclusive breastfeeding reduces the risk of postnatal HIV-1
transmission and increases HIV-free survival.
AIDS. 2005 Apr 29;19(7):699-708.
http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&dopt=Abstract&
db=PubMed&list_uids=15821396
OBJECTIVES:: The promotion of exclusive breastfeeding (EBF) to reduce the
postnatal transmission (PNT) of HIV is based on limited data. In the
context
of a trial of postpartum vitamin A supplementation, we provided education
and counseling about infant feeding and HIV, prospectively collected
information on infant feeding practices, and measured associated infant
infections and deaths. DESIGN AND METHODS:: A total of 14 110
mother-newborn
pairs were enrolled, randomly assigned to vitamin A treatment group after
delivery, and followed for 2 years. At baseline, 6 weeks and 3 months,
mothers were asked whether they were still breastfeeding, and whether any
of
22 liquids or foods had been given to the infant. Breastfed infants were
classified as exclusive, predominant, or mixed breastfed. RESULTS:: A total
of 4495 mothers tested HIV positive at baseline; 2060 of their babies were
alive, polymerase chain reaction negative at 6 weeks, and provided complete
feeding information. All infants initiated breastfeeding. Overall PNT
(defined by a positive HIV test after the 6-week negative test) was 12.1%,
68.2% of which occurred after 6 months. Compared with EBF, early mixed
breastfeeding was associated with a 4.03 (95% CI 0.98, 16.61), 3.79 (95% CI
1.40-10.29), and 2.60 (95% CI 1.21-5.55) greater risk of PNT at 6, 12, and
18 months, respectively. Predominant breastfeeding was associated with a
2.63 (95% CI 0.59-11.67), 2.69 (95% CI 0.95-7.63) and 1.61 (95% CI
0.72-3.64) trend towards greater PNT risk at 6, 12, and 18 months, compared
with EBF. CONCLUSION:: EBF may substantially reduce
breastfeeding-associated
HIV transmission.
PMID: 15821396 [PubMed - as supplied by publisher]
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