Journal article
Late postnatal transmission of HIV-1 in breast-fed children: an individual patient data meta-analysis
The Journal of infectious diseases, Vol.189(12), pp.2154-2166
06/15/2004
DOI: 10.1086/420834
PMID: 15181561
Abstract
We analyzed individual patient data to determine the contribution of late postnatal transmission to the overall risk of mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) and the timing and determinants of late postnatal transmission.
Eligible trials were conducted where breast-feeding was common; included >/=2 HIV-1 tests by 3 months, and, if follow-up continued, >/=2 tests at 3-12 months; and regularly assessed infant-feeding modality. Data on children born before January 2000 were analyzed.
Of 4085 children from 9 trials (breast-fed singletons for whom HIV-1 testing was performed), 993 (24%) were definitively infected (placebo arms, 25.9%; treatment arms, 23.4%; P=.08). Of 539 children with known timing of infection, 225 (42%) had late postnatal transmission. Late postnatal transmission occurred throughout breast-feeding. The estimated hazard function for time to late postnatal transmission was roughly constant. The cumulative probability of late postnatal transmission at 18 months was 9.3%. The overall risk of late postnatal transmission was 8.9 transmissions/100 child-years of breast-feeding and was significantly higher with lower maternal CD4(+) cell counts and male sex.
Late postnatal transmission contributes substantially to overall mother-to-child transmission of HIV-1. The risk of late postnatal transmission is generally constant throughout breast-feeding, and late postnatal transmission is associated with a lower maternal CD4(+) cell count and male sex. Biological and cultural mechanisms underlying the association between sex and late postnatal transmission should be further investigated. Interventions to decrease transmission of HIV-1 through breast-feeding are urgently needed.
Details
- Title: Subtitle
- Late postnatal transmission of HIV-1 in breast-fed children: an individual patient data meta-analysis
- Creators
- Anna CoutsoudisFrancois DabisWafaie FawziPhilippe GaillardGeert HaverkampD Robert HarrisJ Brooks JacksonValerie LeroyNicolas MedaPhilippe MsellatiMarie-Louise NewellRuth NsuatiJennifer S ReadStefan Wiktor
- Resource Type
- Journal article
- Publication Details
- The Journal of infectious diseases, Vol.189(12), pp.2154-2166
- Publisher
- United States
- DOI
- 10.1086/420834
- PMID
- 15181561
- ISSN
- 0022-1899
- eISSN
- 1537-6613
- Language
- English
- Date published
- 06/15/2004
- Academic Unit
- Pathology; VPMA - Administration
- Record Identifier
- 9984047851002771
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