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HIV-free survival at 12-24 months in breastfed infants of HIV-infected women on antiretroviral treatment.
- Source :
-
Tropical Medicine & International Health . Jul2016, Vol. 21 Issue 7, p820-828. 9p. 1 Diagram, 3 Charts, 1 Graph. - Publication Year :
- 2016
-
Abstract
- <bold>Objective: </bold>To provide estimates of HIV-free survival at 12-24 months in breastfed children by maternal ART (6 months or lifelong) to inform WHO HIV and Infant Feeding guidelines.<bold>Methods: </bold>Eighteen studies published 2005-2015 were included in a systematic literature review (1295 papers identified, 156 abstracts screened, 55 full texts); papers were analysed by narrative synthesis and meta-analysis of HIV-free survival by maternal ART regimen in a random effects model. We also grouped studies by feeding modality. Study quality was assessed using a modified Newcastle-Ottawa Scale (NOS) and GRADE.<bold>Results: </bold>The pooled estimates for 12-month HIV-free survival were 89.8% (95% confidence interval, CI: 86.5%, 93.2%) for infants of mothers on ART for 6 months post-natally (six studies) and 91.4% (95% CI 87.5%, 95.4%) for infants of mothers on lifelong ART (three studies). Eighteen-month HIV-free survival estimates were 89.0% (95% CI 83.9%, 94.2%) with 6 months ART (five studies) and 96.1% (95% CI 92.8%, 99.0%) with lifelong ART (three studies). Twenty-four-month HIV-free survival for infants whose mothers were on ART to 6 months post-natally (two studies) was 89.2% (95% CI 79.9%, 98.5%). Heterogeneity was considerable throughout. In four studies, HIV-free survival in breastfed infants ranged from 87% (95% CI 78%, 92%) to 96% (95% CI 91%, 98%) and in formula-fed infants from 67% (95% CI 35.5%, 87.9%) to 97.6% (95% CI 93.0%, 98.2%).<bold>Conclusion: </bold>Our results highlight the importance of breastfeeding for infant survival and of ART in reducing the risk of mother-to-child HIV transmission and support the WHO recommendation to initiate ART for life immediately after HIV diagnosis. [ABSTRACT FROM AUTHOR]
- Subjects :
- *HIV infection transmission
*HIV-positive women
*INFANT disease treatment
*ANTIRETROVIRAL agents
*PROGRESSION-free survival
*CONFIDENCE intervals
*HIV prevention
*HIV infection complications
*VERTICAL transmission (Communicable diseases)
*ANTI-HIV agents
*BREASTFEEDING
*COMMUNICABLE diseases
*PREGNANCY complications
*RESEARCH funding
*SURVIVAL analysis (Biometry)
*SYSTEMATIC reviews
*PREVENTION
Subjects
Details
- Language :
- English
- ISSN :
- 13602276
- Volume :
- 21
- Issue :
- 7
- Database :
- Academic Search Index
- Journal :
- Tropical Medicine & International Health
- Publication Type :
- Academic Journal
- Accession number :
- 116525981
- Full Text :
- https://doi.org/10.1111/tmi.12710