Postpartum weight change among HIV-infected mothers by antiretroviral prophylaxis and infant feeding modality in a research setting
Identifieur interne : 004013 ( Main/Exploration ); précédent : 004012; suivant : 004014Postpartum weight change among HIV-infected mothers by antiretroviral prophylaxis and infant feeding modality in a research setting
Auteurs : Cecile Cames [France] ; Amandine Cournil [France] ; Isabelle De Vincenzi [Suisse] ; Philippe Gaillard [Suisse] ; Nicolas Meda [Burkina Faso] ; Stanley Luchters [Kenya, Belgique, Australie] ; Ruth Nduati [Kenya] ; Kevindra Naidu [Afrique du Sud] ; Marie-Louise Newell [Afrique du Sud] ; Jennifer S. Read [États-Unis] ; Kirsten Bork [France]Source :
- AIDS : (London) [ 0269-9370 ] ; 2014.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
Objective: To assess the relationship between infant feeding, triple-antiretroviral prophylaxis and weight from 2 weeks (baseline) to 6 months postpartum among HIV-infected mothers in a mother-to-child transmission (MTCT) of HIV-prevention trial in five sub-Saharan African sites. Methods: HIV-infected pregnant women with CD4+ cell counts of 200-500 cells/μl were counselled to choose breastfeeding to 6 months or replacement feeding from delivery. They were randomized to receive perinatal zidovudine and single-dose nevirapine or triple-antiretroviral MTCT prophylaxis until breastfeeding cessation. Mixed-effect linear models were used to compare maternal weight trajectories over time by infant feeding mode. Antiretroviral prophylaxis and BMI at baseline were examined as potential effect modifiers. Results: Among 797 mothers, 620 (78%) initiated breastfeeding. Wasting (BMI <18.5) was rare at baseline (2%), whereas overweight/obesity (BMI ≥ 25) was common (40%). In the model including all women, breastfeeding was not associated with weight loss up to 6 months, irrespective of baseline BMI and antiretroviral prophylaxis. Triple-antiretroviral prophylaxis was associated with weight gain among replacement-feeding mothers with baseline BMI at least 25 (+0.54 kg/month; P<0.0001). In the model including breastfeeding mothers only, triple-antiretroviral prophylaxis was associated with weight gain among mothers with baseline BMI at least 25 who ceased breastfeeding before 3 months postpartum (+0.33 kg/month; P=0.03). Conclusion: The results suggest that breastfeeding up to 6 months postpartum is not detrimental for postpartum weight among well nourished HIV-infected mothers at intermediate-disease stage. In the absence of breastfeeding or after weaning, triple-antiretroviral prophylaxis is associated with weight gain among women with high BMI, even after cessation of prophylaxis.
Affiliations:
- Afrique du Sud, Australie, Belgique, Burkina Faso, France, Kenya, Suisse, États-Unis
- Languedoc-Roussillon, Maryland, Occitanie (région administrative), Province de Flandre-Orientale, Région flamande, Victoria (État)
- Gand, Melbourne, Montpellier
- Université de Gand
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change among HIV-infected mothers by antiretroviral prophylaxis and infant feeding modality in a research setting</title><author><name sortKey="Cames, Cecile" sort="Cames, Cecile" uniqKey="Cames C" first="Cecile" last="Cames">Cecile Cames</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Institut de Recherche pour le Développement (IRD)</s1><s2>Montpellier</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Languedoc-Roussillon</region><settlement type="city">Montpellier</settlement></placeName></affiliation></author><author><name sortKey="Cournil, Amandine" sort="Cournil, Amandine" uniqKey="Cournil A" first="Amandine" last="Cournil">Amandine Cournil</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Institut de Recherche pour le Développement (IRD)</s1><s2>Montpellier</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Languedoc-Roussillon</region><settlement type="city">Montpellier</settlement></placeName></affiliation></author><author><name sortKey="De Vincenzi, Isabelle" sort="De Vincenzi, Isabelle" uniqKey="De Vincenzi I" first="Isabelle" last="De Vincenzi">Isabelle De Vincenzi</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>WHO, Reproductive Health and Research</s1><s2>Geneva</s2><s3>CHE</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>Geneva</wicri:noRegion></affiliation></author><author><name sortKey="Gaillard, Philippe" sort="Gaillard, Philippe" uniqKey="Gaillard P" first="Philippe" last="Gaillard">Philippe Gaillard</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>WHO, Reproductive Health and Research</s1><s2>Geneva</s2><s3>CHE</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Suisse</country><wicri:noRegion>Geneva</wicri:noRegion></affiliation></author><author><name sortKey="Meda, Nicolas" sort="Meda, Nicolas" uniqKey="Meda N" first="Nicolas" last="Meda">Nicolas Meda</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Centre Muraz</s1><s2>Bobo-Dioulasso</s2><s3>BFA</s3><sZ>5 aut.</sZ></inist:fA14><country>Burkina Faso</country><wicri:noRegion>Centre Muraz</wicri:noRegion></affiliation></author><author><name sortKey="Luchters, Stanley" sort="Luchters, Stanley" uniqKey="Luchters S" first="Stanley" last="Luchters">Stanley Luchters</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>International Centre for Reproductive Health (ICRH)</s1><s2>Mombasa</s2><s3>KEN</s3><sZ>6 aut.</sZ></inist:fA14><country>Kenya</country><wicri:noRegion>International Centre for Reproductive Health (ICRH)</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="05"><s1>International Centre for Reproductive Health, Ghent University</s1><s3>BEL</s3><sZ>6 aut.</sZ></inist:fA14><country>Belgique</country><placeName><settlement type="city">Gand</settlement><region>Région flamande</region><region type="district" nuts="2">Province de Flandre-Orientale</region></placeName><orgName type="university">Université de Gand</orgName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Centre for International Health, Burnet Institute</s1><s2>Melbourne</s2><s3>AUS</s3><sZ>6 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Nduati, Ruth" sort="Nduati, Ruth" uniqKey="Nduati R" first="Ruth" last="Nduati">Ruth Nduati</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>University of Nairobi</s1><s3>KEN</s3><sZ>7 aut.</sZ></inist:fA14><country>Kenya</country><wicri:noRegion>University of Nairobi</wicri:noRegion></affiliation></author><author><name sortKey="Naidu, Kevindra" sort="Naidu, Kevindra" uniqKey="Naidu K" first="Kevindra" last="Naidu">Kevindra Naidu</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Africa Centre for Health and Population Studies, University of KwaZulu-Natal</s1><s3>ZAF</s3><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Afrique du Sud</country><wicri:noRegion>Africa Centre for Health and Population Studies, University of KwaZulu-Natal</wicri:noRegion></affiliation></author><author><name sortKey="Newell, Marie Louise" sort="Newell, Marie Louise" uniqKey="Newell M" first="Marie-Louise" last="Newell">Marie-Louise Newell</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Africa Centre for Health and Population Studies, University of KwaZulu-Natal</s1><s3>ZAF</s3><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Afrique du Sud</country><wicri:noRegion>Africa Centre for Health and Population Studies, University of KwaZulu-Natal</wicri:noRegion></affiliation></author><author><name sortKey="Read, Jennifer S" sort="Read, Jennifer S" uniqKey="Read J" first="Jennifer S." last="Read">Jennifer S. Read</name><affiliation wicri:level="2"><inist:fA14 i1="09"><s1>Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health</s1><s2>Bethesda, Maryland</s2><s3>USA</s3><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>NVPO/OASH/OS/DHHS</s1><s2>Washington, DC</s2><s3>USA</s3><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>NVPO/OASH/OS/DHHS</wicri:noRegion></affiliation></author><author><name sortKey="Bork, Kirsten" sort="Bork, Kirsten" uniqKey="Bork K" first="Kirsten" last="Bork">Kirsten Bork</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Institut de Recherche pour le Développement (IRD)</s1><s2>Montpellier</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Languedoc-Roussillon</region><settlement type="city">Montpellier</settlement></placeName></affiliation></author></analytic><series><title level="j" type="main">AIDS : (London)</title><title level="j" type="abbreviated">AIDS : (Lond.)</title><idno type="ISSN">0269-9370</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">AIDS : (London)</title><title level="j" type="abbreviated">AIDS : (Lond.)</title><idno type="ISSN">0269-9370</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>AIDS</term><term>Africa</term><term>Antiretroviral agent</term><term>Antiviral</term><term>Body weight</term><term>Breast feeding</term><term>Feeding</term><term>Infant</term><term>Maternal diseases</term><term>Overweight</term><term>Prevention</term><term>Puerperium</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Pathologie de la mère</term><term>SIDA</term><term>Surcharge pondérale</term><term>Antiviral</term><term>Postpartum</term><term>Antirétroviral</term><term>Prévention</term><term>Nourrisson</term><term>Alimentation</term><term>Afrique</term><term>Poids corporel</term><term>Allaitement</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective: To assess the relationship between infant feeding, triple-antiretroviral prophylaxis and weight from 2 weeks (baseline) to 6 months postpartum among HIV-infected mothers in a mother-to-child transmission (MTCT) of HIV-prevention trial in five sub-Saharan African sites. Methods: HIV-infected pregnant women with CD4<sup>+</sup> cell counts of 200-500 cells/μl were counselled to choose breastfeeding to 6 months or replacement feeding from delivery. They were randomized to receive perinatal zidovudine and single-dose nevirapine or triple-antiretroviral MTCT prophylaxis until breastfeeding cessation. Mixed-effect linear models were used to compare maternal weight trajectories over time by infant feeding mode. Antiretroviral prophylaxis and BMI at baseline were examined as potential effect modifiers. Results: Among 797 mothers, 620 (78%) initiated breastfeeding. Wasting (BMI <18.5) was rare at baseline (2%), whereas overweight/obesity (BMI ≥ 25) was common (40%). In the model including all women, breastfeeding was not associated with weight loss up to 6 months, irrespective of baseline BMI and antiretroviral prophylaxis. Triple-antiretroviral prophylaxis was associated with weight gain among replacement-feeding mothers with baseline BMI at least 25 (+0.54 kg/month; P<0.0001). In the model including breastfeeding mothers only, triple-antiretroviral prophylaxis was associated with weight gain among mothers with baseline BMI at least 25 who ceased breastfeeding before 3 months postpartum (+0.33 kg/month; P=0.03). Conclusion: The results suggest that breastfeeding up to 6 months postpartum is not detrimental for postpartum weight among well nourished HIV-infected mothers at intermediate-disease stage. In the absence of breastfeeding or after weaning, triple-antiretroviral prophylaxis is associated with weight gain among women with high BMI, even after cessation of prophylaxis.</div></front></TEI><affiliations><list><country><li>Afrique du Sud</li><li>Australie</li><li>Belgique</li><li>Burkina Faso</li><li>France</li><li>Kenya</li><li>Suisse</li><li>États-Unis</li></country><region><li>Languedoc-Roussillon</li><li>Maryland</li><li>Occitanie (région administrative)</li><li>Province de Flandre-Orientale</li><li>Région flamande</li><li>Victoria (État)</li></region><settlement><li>Gand</li><li>Melbourne</li><li>Montpellier</li></settlement><orgName><li>Université de Gand</li></orgName></list><tree><country name="France"><region name="Occitanie (région administrative)"><name sortKey="Cames, Cecile" sort="Cames, Cecile" uniqKey="Cames C" first="Cecile" last="Cames">Cecile Cames</name></region><name sortKey="Bork, Kirsten" sort="Bork, Kirsten" uniqKey="Bork K" first="Kirsten" last="Bork">Kirsten Bork</name><name sortKey="Cournil, Amandine" sort="Cournil, Amandine" uniqKey="Cournil A" first="Amandine" last="Cournil">Amandine Cournil</name></country><country name="Suisse"><noRegion><name sortKey="De Vincenzi, Isabelle" sort="De Vincenzi, Isabelle" uniqKey="De Vincenzi I" first="Isabelle" last="De Vincenzi">Isabelle De Vincenzi</name></noRegion><name sortKey="Gaillard, Philippe" sort="Gaillard, Philippe" uniqKey="Gaillard P" first="Philippe" last="Gaillard">Philippe Gaillard</name></country><country name="Burkina Faso"><noRegion><name sortKey="Meda, Nicolas" sort="Meda, Nicolas" uniqKey="Meda N" first="Nicolas" last="Meda">Nicolas Meda</name></noRegion></country><country name="Kenya"><noRegion><name sortKey="Luchters, Stanley" sort="Luchters, Stanley" uniqKey="Luchters S" first="Stanley" last="Luchters">Stanley Luchters</name></noRegion><name sortKey="Nduati, Ruth" sort="Nduati, Ruth" uniqKey="Nduati R" first="Ruth" last="Nduati">Ruth Nduati</name></country><country name="Belgique"><region name="Région flamande"><name sortKey="Luchters, Stanley" sort="Luchters, Stanley" uniqKey="Luchters S" first="Stanley" last="Luchters">Stanley Luchters</name></region></country><country name="Australie"><region name="Victoria (État)"><name sortKey="Luchters, Stanley" sort="Luchters, Stanley" uniqKey="Luchters S" first="Stanley" last="Luchters">Stanley Luchters</name></region></country><country name="Afrique du Sud"><noRegion><name sortKey="Naidu, Kevindra" sort="Naidu, Kevindra" uniqKey="Naidu K" first="Kevindra" last="Naidu">Kevindra Naidu</name></noRegion><name sortKey="Newell, Marie Louise" sort="Newell, Marie Louise" uniqKey="Newell M" first="Marie-Louise" last="Newell">Marie-Louise Newell</name></country><country name="États-Unis"><region name="Maryland"><name sortKey="Read, Jennifer S" sort="Read, Jennifer S" uniqKey="Read J" first="Jennifer S." last="Read">Jennifer S. 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