Journal article
Effect of Postnatal HIV Treatment on Clinical Mastitis and Breast Inflammation in HIV-Infected Breast-feeding Women
Paediatric and perinatal epidemiology, Vol.31(2), pp.134-143
03/01/2017
DOI: 10.1111/ppe.12337
PMCID: 6029881
PMID: 28205255
Abstract
Background: The relationship between mastitis and antiretroviral therapy among HIV-positive, breast-feeding women is unclear.
Methods: In the Breastfeeding, Antiretrovirals, and Nutrition (BAN) study, conducted in Lilongwe, Malawi, 2369 mother-infant pairs were randomized to a nutritional supplement group and to one of three treatment groups: maternal antiretroviral therapy (ART), infant nevirapine (NVP) or standard of care for 24weeks of exclusive breast-feeding and 4weeks of weaning. Among 1472 HIV-infected women who delivered live infants between 2004 and 2007, we estimated cumulative incidence functions and sub-distribution hazard ratios (HR) of mastitis or breast inflammation comparing women in maternal ART (n = 487) or infant nevirapine (n = 492) groups to the standard of care (n = 493). Nutritional supplement groups (743 took, 729 did not) were also compared.
Results: Through 28-weeks post-partum, 102 of 1472 women experienced at least one occurrence of mastitis or breast inflammation. The 28-week risk was higher for maternal ART (risk difference (RD) 4.5, 95% confidence interval (CI) 0.9, 8.1) and infant NVP (RD 3.6, 95% CI 0.3, 6.9) compared to standard of care. The hazard of late-appearing mastitis or breast inflammation (from week 5-28) was also higher for maternal ART (HR 6.7, 95% CI 2.0, 22.6) and infant NVP (HR 5.1, 95% CI 1.5, 17. 5) compared to the standard of care.
Conclusions: Mastitis or breast inflammation while breast-feeding is a possible side effect for women taking prophylactic ART and women whose infants take NVP, warranting additional research in the context of postnatal HIV transmission.
Details
- Title: Subtitle
- Effect of Postnatal HIV Treatment on Clinical Mastitis and Breast Inflammation in HIV-Infected Breast-feeding Women
- Creators
- Sabrina Zadrozny - University of North Carolina at Chapel HillDaniel Westreich - University of North Carolina at Chapel HillMichael G. Hudgens - University of North Carolina at Chapel HillCharles Chasela - University of the WitwatersrandDenise J. Jamieson - National Center for Chronic Disease Prevention and Health PromotionFrancis Martinson - UNC Project, Lilongwe, MalawiChifundo Zimba - UNC Project, Lilongwe, MalawiGerald Tegha - UNC Project, Lilongwe, MalawiIrving Hoffman - University of North Carolina at Chapel HillWilliam C. Miller - The Ohio State UniversityBrian W. Pence - University of North Carolina at Chapel HillCaroline C. King - Centers for Disease Control and PreventionAthena P. Kourtis - Centers for Disease Control and PreventionWezi Msungama - Ctr Dis Control Malawi, Hlth Serv Branch, Lilongwe, MalawiCharles van der Horst - University of North Carolina at Chapel HillBreastfeeding, Antiretrovirals and Nutrition (BAN) Study Team
- Resource Type
- Journal article
- Publication Details
- Paediatric and perinatal epidemiology, Vol.31(2), pp.134-143
- Publisher
- Wiley
- DOI
- 10.1111/ppe.12337
- PMID
- 28205255
- PMCID
- 6029881
- ISSN
- 0269-5022
- eISSN
- 1365-3016
- Number of pages
- 10
- Grant note
- 2-D43 TW01039-06; R24 TW007988 / NIH Fogarty AIDS International Training and Research Program Bristol-Myers Squibb US Agency for International Development; United States Agency for International Development (USAID) Elizabeth Glaser Pediatric AIDS Foundation U48DP001944 / NATIONAL CENTER FOR CHRONIC DISEASE PREV AND HEALTH PROMO; United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA Johnson and Johnson; Johnson & Johnson; Johnson & Johnson USA SIP 13-01 U48-CCU409660-09; SIP 26-04 U48-DP00005901; SIP 22-09 U48-DP001944-01 / Prevention Research Centers Special Interest Project of the Centers for Disease Control and Prevention R25TW009340-03S4 / Fogarty Clayton-Dedonder Global Health Mentorship Program P30AI050410 / NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID) DP2HD084070 / EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) GlaxoSmithKline Abbott Laboratories P30-AI50410 / University of North Carolina Center for AIDS Research World Food Program National Institute of Allergy and Infectious Diseases; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID) Roche Pharmaceuticals; Roche Holding Malawi Ministry of Health and Population Boehringer Ingelheim United Nations Children's Fund R24TW007988 / FOGARTY INTERNATIONAL CENTER; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Fogarty International Center (FIC)
- Language
- English
- Date published
- 03/01/2017
- Academic Unit
- Obstetrics and Gynecology; VPMA - Administration
- Record Identifier
- 9984446519902771
Metrics
3 Record Views