| Titre : | Influence of infant-feeding patterns on early mother-to-child transmission of HIV-1 in Durban, South Africa. (1999) |
| Auteurs : | A. COUTSOUDIS ; et al. |
| Type de document : | Article |
| Dans : | Lancet (The) (vol. 354, n° 9177, 1999/08/07) |
| Pagination : | 471-476 |
| Langues: | Anglais |
| Mots-clés : | VIH ; Allaitement maternel ; Contagion verticale ; Afrique du Sud ; Vitamine A ; Nourrisson ; Mère |
| Résumé : | The observation that mother-to-child transmission of HIV-1 can occur through breastfeeding has resulted in policies that recommend avoidance of breastfeeding by HIV-1-infected women in the developed world and under specific circumstances in developing countries. WE compared transmission rates in exclusively breastfed, mixed-fed and formula-fed (never breastfed) infants to assess whether the pattern of breastfeeding is a critical determinant of early mother-to-child transmission of HIV-1. Methods We prospectively assessed infant-feeding practices of 549 HIV-1 infected women who were part of a vitamin A intervention trial in Durban, South Africa. The proportions of HIV-infected infants at 3-months (estimated by use of Kaplan-Meier life tables) were compared in the three different feeding groups. HIV-infection was defined by a positive RNA-PCR test. Findings : At 3 months, 18.8% (95% Cl 12.6-24.9) of 156 never-breastfed children were estimated to be HIV-1 infected compared with 21.3% (17.2-25.5) of 393 breastfed childre (p=0.5). The estimated proportion (Kaplan-Meier) of infants HIV-1 infected by 3 mths was significantly lower for those exclusively breastfed to 3 mths than in those who received mixed feeding before 3 mths (14.6% [7.7-21.4] vs 24.1% [19.0-29.2], p=0.03). After adjustment for potential confounders (...) exclusive breastfeeding carried a significantly lower risk of HIV-1 transmission than mixed feeding (...) and a similar risk to no breastfeeding (...). |
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