Reduced Mortality Associated With Breast-Feeding-Acquired HIV Infection and Breast-Feeding Among HIV-Infected Children in Zambia
Identifieur interne : 000543 ( PascalFrancis/Corpus ); précédent : 000542; suivant : 000544Reduced Mortality Associated With Breast-Feeding-Acquired HIV Infection and Breast-Feeding Among HIV-Infected Children in Zambia
Auteurs : Matthew P. Fox ; Daniel Brooks ; Louise Kuhn ; Grace Aldrovandi ; Moses Sinkala ; Chipepo Kankasa ; Mwiya Mwiya ; Robert Horsburgh ; Donald M. TheaSource :
- Journal of acquired immune deficiency syndromes : (1999) [ 1525-4135 ] ; 2008.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
Objectives: In developing countries, where mother-to-child transmission of HIV through breast-feeding is common, little is known about the impact of postpartum transmission on child survival. This study assessed whether children infected postpartum have longer survival from time of infection versus those infected during gestation or delivery. Design: We used a prospective cohort study to analyze data from 213 HIV-infected children enrolled in a breast-feeding intervention trial in Lusaka, Zambia (2001 to 2004). Methods: We compared mortality 1 year after HIV infection in children stratified by age of infection: 0 to 3 days (intrauterine [IU] group), 4 to 40 days (intrapartum/early postpartum [IP/EPP] group), and >40 days (postpartum [PP] group). Results: A total of 61, 71, and 81 children were infected in the IU, IP/EPP, and PP groups, respectively. Children with intrauterine or intrapartum/early postpartum transmission had higher mortality over the first 12 months after infection than children with postpartum transmission (P = 0.001 and P = 0.006, respectively); no differences were detected between children with intrauterine and intrapartum/ early postpartum transmission. Nearly 20% of the IU and IP/EPP groups died by 100 days after infection, whereas nearly 10% of the PP group had died by this time. After adjusting for birth weight, maternal CD4 cell count, breast-feeding, and maternal death, children infected postpartum had one quarter the mortality rate (hazard ratio [HR] = 0.27, 95% confidence interval [CI]: 0.15 to 0.50) of those infected in utero. Stopping breast-feeding increased mortality in infected children (HR = 3.1, 95% CI: 1.8 to 5.3). Conclusions: This study demonstrates a survival benefit among children infected postpartum versus children infected during pregnancy or delivery and a benefit to increased breast-feeding duration among infected children. Testing children for HIV early may provide a means to allow for earlier intervention.
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Pour connaître la documentation sur le format Inist Standard.
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Format Inist (serveur)
NO : | PASCAL 08-0263793 INIST |
---|---|
ET : | Reduced Mortality Associated With Breast-Feeding-Acquired HIV Infection and Breast-Feeding Among HIV-Infected Children in Zambia |
AU : | FOX (Matthew P.); BROOKS (Daniel); KUHN (Louise); ALDROVANDI (Grace); SINKALA (Moses); KANKASA (Chipepo); MWIYA (Mwiya); HORSBURGH (Robert); THEA (Donald M.) |
AF : | Center for International Health and Development, Boston University/Boston, MA/Etats-Unis (1 aut., 9 aut.); Department of Epidemiology, Boston University/Boston, MA/Etats-Unis (2 aut., 8 aut.); Sergievsky Center and Department of Epidemiology, Mailman School of Public Health, Columbia University/New York, NY/Etats-Unis (3 aut.); Childrens Hospital of Los Angeles/Los Angeles, CA/Etats-Unis (4 aut.); Lusaka District Health Management Team/Lusaka/Zambie (5 aut.); University Teaching Hospital, University of Zambia/Lusaka/Zambie (6 aut., 7 aut.) |
DT : | Publication en série; Niveau analytique |
SO : | Journal of acquired immune deficiency syndromes : (1999); ISSN 1525-4135; Etats-Unis; Da. 2008; Vol. 48; No. 1; Pp. 90-96; Bibl. 24 ref. |
LA : | Anglais |
EA : | Objectives: In developing countries, where mother-to-child transmission of HIV through breast-feeding is common, little is known about the impact of postpartum transmission on child survival. This study assessed whether children infected postpartum have longer survival from time of infection versus those infected during gestation or delivery. Design: We used a prospective cohort study to analyze data from 213 HIV-infected children enrolled in a breast-feeding intervention trial in Lusaka, Zambia (2001 to 2004). Methods: We compared mortality 1 year after HIV infection in children stratified by age of infection: 0 to 3 days (intrauterine [IU] group), 4 to 40 days (intrapartum/early postpartum [IP/EPP] group), and >40 days (postpartum [PP] group). Results: A total of 61, 71, and 81 children were infected in the IU, IP/EPP, and PP groups, respectively. Children with intrauterine or intrapartum/early postpartum transmission had higher mortality over the first 12 months after infection than children with postpartum transmission (P = 0.001 and P = 0.006, respectively); no differences were detected between children with intrauterine and intrapartum/ early postpartum transmission. Nearly 20% of the IU and IP/EPP groups died by 100 days after infection, whereas nearly 10% of the PP group had died by this time. After adjusting for birth weight, maternal CD4 cell count, breast-feeding, and maternal death, children infected postpartum had one quarter the mortality rate (hazard ratio [HR] = 0.27, 95% confidence interval [CI]: 0.15 to 0.50) of those infected in utero. Stopping breast-feeding increased mortality in infected children (HR = 3.1, 95% CI: 1.8 to 5.3). Conclusions: This study demonstrates a survival benefit among children infected postpartum versus children infected during pregnancy or delivery and a benefit to increased breast-feeding duration among infected children. Testing children for HIV early may provide a means to allow for earlier intervention. |
CC : | 002A05C10; 002B05C02J; 002B05C02D |
FD : | Virus immunodéficience humaine; Allaitement; Enfant; Zambie; Nourrisson; Transmission verticale; Microbiologie; Virologie; SIDA |
FG : | Lentivirus; Retroviridae; Virus; Homme; Afrique; Immunodéficit; Virose; Infection; Immunopathologie |
ED : | Human immunodeficiency virus; Breast feeding; Child; Zambia; Infant; Vertical transmission; Microbiology; Virology; AIDS |
EG : | Lentivirus; Retroviridae; Virus; Human; Africa; Immune deficiency; Viral disease; Infection; Immunopathology |
SD : | Human immunodeficiency virus; Lactancia; Niño; Zambia; Lactante; Transmisión vertical; Microbiología; Virología; SIDA |
LO : | INIST-21576.354000183084610120 |
ID : | 08-0263793 |
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Pascal:08-0263793Le document en format XML
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<term>Microbiology</term>
<term>Vertical transmission</term>
<term>Virology</term>
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<term>Allaitement</term>
<term>Enfant</term>
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<front><div type="abstract" xml:lang="en">Objectives: In developing countries, where mother-to-child transmission of HIV through breast-feeding is common, little is known about the impact of postpartum transmission on child survival. This study assessed whether children infected postpartum have longer survival from time of infection versus those infected during gestation or delivery. Design: We used a prospective cohort study to analyze data from 213 HIV-infected children enrolled in a breast-feeding intervention trial in Lusaka, Zambia (2001 to 2004). Methods: We compared mortality 1 year after HIV infection in children stratified by age of infection: 0 to 3 days (intrauterine [IU] group), 4 to 40 days (intrapartum/early postpartum [IP/EPP] group), and >40 days (postpartum [PP] group). Results: A total of 61, 71, and 81 children were infected in the IU, IP/EPP, and PP groups, respectively. Children with intrauterine or intrapartum/early postpartum transmission had higher mortality over the first 12 months after infection than children with postpartum transmission (P = 0.001 and P = 0.006, respectively); no differences were detected between children with intrauterine and intrapartum/ early postpartum transmission. Nearly 20% of the IU and IP/EPP groups died by 100 days after infection, whereas nearly 10% of the PP group had died by this time. After adjusting for birth weight, maternal CD4 cell count, breast-feeding, and maternal death, children infected postpartum had one quarter the mortality rate (hazard ratio [HR] = 0.27, 95% confidence interval [CI]: 0.15 to 0.50) of those infected in utero. Stopping breast-feeding increased mortality in infected children (HR = 3.1, 95% CI: 1.8 to 5.3). Conclusions: This study demonstrates a survival benefit among children infected postpartum versus children infected during pregnancy or delivery and a benefit to increased breast-feeding duration among infected children. Testing children for HIV early may provide a means to allow for earlier intervention.</div>
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<fC01 i1="01" l="ENG"><s0>Objectives: In developing countries, where mother-to-child transmission of HIV through breast-feeding is common, little is known about the impact of postpartum transmission on child survival. This study assessed whether children infected postpartum have longer survival from time of infection versus those infected during gestation or delivery. Design: We used a prospective cohort study to analyze data from 213 HIV-infected children enrolled in a breast-feeding intervention trial in Lusaka, Zambia (2001 to 2004). Methods: We compared mortality 1 year after HIV infection in children stratified by age of infection: 0 to 3 days (intrauterine [IU] group), 4 to 40 days (intrapartum/early postpartum [IP/EPP] group), and >40 days (postpartum [PP] group). Results: A total of 61, 71, and 81 children were infected in the IU, IP/EPP, and PP groups, respectively. Children with intrauterine or intrapartum/early postpartum transmission had higher mortality over the first 12 months after infection than children with postpartum transmission (P = 0.001 and P = 0.006, respectively); no differences were detected between children with intrauterine and intrapartum/ early postpartum transmission. Nearly 20% of the IU and IP/EPP groups died by 100 days after infection, whereas nearly 10% of the PP group had died by this time. After adjusting for birth weight, maternal CD4 cell count, breast-feeding, and maternal death, children infected postpartum had one quarter the mortality rate (hazard ratio [HR] = 0.27, 95% confidence interval [CI]: 0.15 to 0.50) of those infected in utero. Stopping breast-feeding increased mortality in infected children (HR = 3.1, 95% CI: 1.8 to 5.3). Conclusions: This study demonstrates a survival benefit among children infected postpartum versus children infected during pregnancy or delivery and a benefit to increased breast-feeding duration among infected children. Testing children for HIV early may provide a means to allow for earlier intervention.</s0>
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<s5>09</s5>
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<s5>11</s5>
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<s5>12</s5>
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<s5>14</s5>
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<s5>14</s5>
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<s5>14</s5>
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<s5>13</s5>
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<fC07 i1="09" i2="X" l="SPA"><s0>Inmunopatología</s0>
<s5>17</s5>
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<server><NO>PASCAL 08-0263793 INIST</NO>
<ET>Reduced Mortality Associated With Breast-Feeding-Acquired HIV Infection and Breast-Feeding Among HIV-Infected Children in Zambia</ET>
<AU>FOX (Matthew P.); BROOKS (Daniel); KUHN (Louise); ALDROVANDI (Grace); SINKALA (Moses); KANKASA (Chipepo); MWIYA (Mwiya); HORSBURGH (Robert); THEA (Donald M.)</AU>
<AF>Center for International Health and Development, Boston University/Boston, MA/Etats-Unis (1 aut., 9 aut.); Department of Epidemiology, Boston University/Boston, MA/Etats-Unis (2 aut., 8 aut.); Sergievsky Center and Department of Epidemiology, Mailman School of Public Health, Columbia University/New York, NY/Etats-Unis (3 aut.); Childrens Hospital of Los Angeles/Los Angeles, CA/Etats-Unis (4 aut.); Lusaka District Health Management Team/Lusaka/Zambie (5 aut.); University Teaching Hospital, University of Zambia/Lusaka/Zambie (6 aut., 7 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>Journal of acquired immune deficiency syndromes : (1999); ISSN 1525-4135; Etats-Unis; Da. 2008; Vol. 48; No. 1; Pp. 90-96; Bibl. 24 ref.</SO>
<LA>Anglais</LA>
<EA>Objectives: In developing countries, where mother-to-child transmission of HIV through breast-feeding is common, little is known about the impact of postpartum transmission on child survival. This study assessed whether children infected postpartum have longer survival from time of infection versus those infected during gestation or delivery. Design: We used a prospective cohort study to analyze data from 213 HIV-infected children enrolled in a breast-feeding intervention trial in Lusaka, Zambia (2001 to 2004). Methods: We compared mortality 1 year after HIV infection in children stratified by age of infection: 0 to 3 days (intrauterine [IU] group), 4 to 40 days (intrapartum/early postpartum [IP/EPP] group), and >40 days (postpartum [PP] group). Results: A total of 61, 71, and 81 children were infected in the IU, IP/EPP, and PP groups, respectively. Children with intrauterine or intrapartum/early postpartum transmission had higher mortality over the first 12 months after infection than children with postpartum transmission (P = 0.001 and P = 0.006, respectively); no differences were detected between children with intrauterine and intrapartum/ early postpartum transmission. Nearly 20% of the IU and IP/EPP groups died by 100 days after infection, whereas nearly 10% of the PP group had died by this time. After adjusting for birth weight, maternal CD4 cell count, breast-feeding, and maternal death, children infected postpartum had one quarter the mortality rate (hazard ratio [HR] = 0.27, 95% confidence interval [CI]: 0.15 to 0.50) of those infected in utero. Stopping breast-feeding increased mortality in infected children (HR = 3.1, 95% CI: 1.8 to 5.3). Conclusions: This study demonstrates a survival benefit among children infected postpartum versus children infected during pregnancy or delivery and a benefit to increased breast-feeding duration among infected children. Testing children for HIV early may provide a means to allow for earlier intervention.</EA>
<CC>002A05C10; 002B05C02J; 002B05C02D</CC>
<FD>Virus immunodéficience humaine; Allaitement; Enfant; Zambie; Nourrisson; Transmission verticale; Microbiologie; Virologie; SIDA</FD>
<FG>Lentivirus; Retroviridae; Virus; Homme; Afrique; Immunodéficit; Virose; Infection; Immunopathologie</FG>
<ED>Human immunodeficiency virus; Breast feeding; Child; Zambia; Infant; Vertical transmission; Microbiology; Virology; AIDS</ED>
<EG>Lentivirus; Retroviridae; Virus; Human; Africa; Immune deficiency; Viral disease; Infection; Immunopathology</EG>
<SD>Human immunodeficiency virus; Lactancia; Niño; Zambia; Lactante; Transmisión vertical; Microbiología; Virología; SIDA</SD>
<LO>INIST-21576.354000183084610120</LO>
<ID>08-0263793</ID>
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