SidaSubSaharaV1, PascalFrancis, Corpus, bibRecord, 000543

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 : 000544

Reduced 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. Thea

Source :

Journal of acquired immune deficiency syndromes : (1999) [ 1525-4135 ] ; 2008.

RBID : Pascal:08-0263793

Descripteurs français

Pascal (Inist)
- Virus immunodéficience humaine, Allaitement, Enfant, Zambie, Nourrisson, Transmission verticale, Microbiologie, Virologie, SIDA.

English descriptors

KwdEn :
- AIDS, Breast feeding, Child, Human immunodeficiency virus, Infant, Microbiology, Vertical transmission, Virology, Zambia.

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.

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

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A11	`01`	`1`		`@1 FOX (Matthew P.)`
A11	`02`	`1`		`@1 BROOKS (Daniel)`
A11	`03`	`1`		`@1 KUHN (Louise)`
A11	`04`	`1`		`@1 ALDROVANDI (Grace)`
A11	`05`	`1`		`@1 SINKALA (Moses)`
A11	`06`	`1`		`@1 KANKASA (Chipepo)`
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A11	`09`	`1`		`@1 THEA (Donald M.)`
A14	`01`			`@1 Center for International Health and Development, Boston University @2 Boston, MA @3 USA @Z 1 aut. @Z 9 aut.`
A14	`02`			`@1 Department of Epidemiology, Boston University @2 Boston, MA @3 USA @Z 2 aut. @Z 8 aut.`
A14	`03`			`@1 Sergievsky Center and Department of Epidemiology, Mailman School of Public Health, Columbia University @2 New York, NY @3 USA @Z 3 aut.`
A14	`04`			`@1 Childrens Hospital of Los Angeles @2 Los Angeles, CA @3 USA @Z 4 aut.`
A14	`05`			`@1 Lusaka District Health Management Team @2 Lusaka @3 ZMB @Z 5 aut.`
A14	`06`			`@1 University Teaching Hospital, University of Zambia @2 Lusaka @3 ZMB @Z 6 aut. @Z 7 aut.`
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C01	`01`		`ENG`	@0 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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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:08-0263793

Le document en format XML

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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>
</front>
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<inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>1525-4135</s0>
</fA01>
<fA03 i2="1"><s0>J. acquir. immune defic. syndr. : (1999)</s0>
</fA03>
<fA05><s2>48</s2>
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<fA06><s2>1</s2>
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<fA08 i1="01" i2="1" l="ENG"><s1>Reduced Mortality Associated With Breast-Feeding-Acquired HIV Infection and Breast-Feeding Among HIV-Infected Children in Zambia</s1>
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<fA11 i1="01" i2="1"><s1>FOX (Matthew P.)</s1>
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<fA11 i1="04" i2="1"><s1>ALDROVANDI (Grace)</s1>
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<fA11 i1="05" i2="1"><s1>SINKALA (Moses)</s1>
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<fA11 i1="06" i2="1"><s1>KANKASA (Chipepo)</s1>
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<fA11 i1="07" i2="1"><s1>MWIYA (Mwiya)</s1>
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<fA11 i1="08" i2="1"><s1>HORSBURGH (Robert)</s1>
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<fA11 i1="09" i2="1"><s1>THEA (Donald M.)</s1>
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<fA14 i1="01"><s1>Center for International Health and Development, Boston University</s1>
<s2>Boston, MA</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>9 aut.</sZ>
</fA14>
<fA14 i1="02"><s1>Department of Epidemiology, Boston University</s1>
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<sZ>2 aut.</sZ>
<sZ>8 aut.</sZ>
</fA14>
<fA14 i1="03"><s1>Sergievsky Center and Department of Epidemiology, Mailman School of Public Health, Columbia University</s1>
<s2>New York, NY</s2>
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<sZ>3 aut.</sZ>
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<fA14 i1="04"><s1>Childrens Hospital of Los Angeles</s1>
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<sZ>5 aut.</sZ>
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<fA14 i1="06"><s1>University Teaching Hospital, University of Zambia</s1>
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<s3>ZMB</s3>
<sZ>6 aut.</sZ>
<sZ>7 aut.</sZ>
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<fA64 i1="01" i2="1"><s0>Journal of acquired immune deficiency syndromes : (1999)</s0>
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<fA66 i1="01"><s0>USA</s0>
</fA66>
<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>
</fC01>
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<s2>NW</s2>
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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>
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Reduced Mortality Associated With Breast-Feeding-Acquired HIV Infection and Breast-Feeding Among HIV-Infected Children in Zambia

Reduced Mortality Associated With Breast-Feeding-Acquired HIV Infection and Breast-Feeding Among HIV-Infected Children in Zambia

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