John-Stewart G,Mbori-Ngacha D, Ekpini R, Janoff EN, Nkengasong J, Read JS, Van de Perre P, Newell ML; Ghent IAS Working Group on HIV in Women Children. Breast-feeding and Transmission of HIV-1. J Acquir Immune Defic Syndr. 2004 Feb 1;35(2):196-202.

Citation:
MBORI- PROFNGACHADOROTHYA. "John-Stewart G,Mbori-Ngacha D, Ekpini R, Janoff EN, Nkengasong J, Read JS, Van de Perre P, Newell ML; Ghent IAS Working Group on HIV in Women Children. Breast-feeding and Transmission of HIV-1. J Acquir Immune Defic Syndr. 2004 Feb 1;35(2):196-202.". In: J Acquir Immune Defic Syndr.2004 Feb 1;35(2):196-202. Earthscan, London. 978-1-84407-469-3 (*); 2004.

Abstract:

Centre for Clinical Research, Kenya Medical Research Institute, University of Nairobi, Nairobi, Kenya. Background. There is conflicting evidence regarding the effects of breast-feeding on maternal mortality from human immunodeficiency virus type 1 (HIV-1) infection, and little is known about the effects of breast-feeding on markers of HIV-1 disease progression.Methods. HIV-1-seropositive women were enrolled during pregnancy and received short-course zidovudine. HIV-1 RNA levels and CD4 cell counts were determined at baseline and at months 1, 3, 6, 12, 18, and 24 postpartum and were compared between breast-feeding and formula-feeding mothers.Results. Of 296 women, 98 formula fed and 198 breast-fed. At baseline, formula-feeding women had a higher education level and prevalence of HIV-1-related illness than did breast-feeding women; however, the groups did not differ with respect to CD4 cell counts and HIV-1 RNA levels. Between months 1 and 24 postpartum, CD4 cell counts decreased 3.9 cells/ mu L/month (P<.001), HIV-1 RNA levels increased 0.005 log(10) copies/mL/month (P=.03), and body mass index (BMI) decreased 0.03 kg/m(2)/month (P<.001). The rate of CD4 cell count decline was higher in breast-feeding mothers (7.2 cells/ mu L/month) than in mothers who never breast-fed (4.0 cells/ mu L/month) (P=.01). BMI decreased more rapidly in breast-feeding women (P=.04), whereas HIV-1 RNA levels and mortality did not differ significantly between breast-feeding and formula-feeding women.Conclusions. Breast-feeding was associated with significant decreases in CD4 cell counts and BMI. HIV-1 RNA levels and mortality were not increased, suggesting a limited adverse impact of breast-feeding in mothers receiving extended care for HIV-1 infection.

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