Abstract
OBJECTIVE: To assess serious gastroenteritis risk and mortality associated with early cessation of breastfeeding in infants enrolled in 2 prevention of maternal-to-child HIV-transmission trials in Uganda. METHODS: We used hazard rates to evaluate serious gastroenteritis events by month of age and mortality among HIV-exposed uninfected infants enrolled in the HIV Network for Prevention Trials (HIVNET 012) (1997-2001) and HIV hyperimmune globulin (HIVIGLOB)/nevirapine (NVP) (2004-2007) trials. HIV-infected mothers were counseled using local infant feeding guidelines current at the time. RESULTS: Breastfeeding cessation occurred earlier in HIVIGLOB/NVP compared with HIVNET 012 (median 4.0 versus 9.3 months, P <0.001). Rates of serious gastroenteritis were higher in HIVIGLOB/NVP (8.0/1000 child-months) than in HIVNET 012 (3.1/1000 child-months; P <0.001). Serious gastroenteritis events also peaked earlier at 3-4 and 7-8 months (16.2/1000 and 15.0/1000 child-months, respectively) compared with HIVNET 012 at 9-10 months (20.8/1000 child-months). All cause infant mortality did not statistically differ between the HIVIGLOB/NVP and the HIVNET 012 trials [3.2/1000 versus 2.0/1000 child-months, respectively (P = 0.10)]. CONCLUSIONS: Early breastfeeding cessation seen in the HIVIGLOB/NVP trial was associated with increased risk of serious gastroenteritis among HIV-exposed uninfected infants when compared with later breastfeeding cessation in the HIVNET 012 trial. Testing interventions, which could decrease HIV transmission through breastfeeding and allow safe breastfeeding into the second year of life, are urgently needed.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 20-27 |
| Number of pages | 8 |
| Journal | Journal of Acquired Immune Deficiency Syndromes |
| Volume | 53 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2010 |
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Keywords
- Breastfeeding cessation
- HIV
- Infants
- Mortality
- Serious gastroenteritis
- Uganda
ASJC Scopus subject areas
- Infectious Diseases
- Pharmacology (medical)
Cite this
Early weaning of hiv-exposed uninfected infants and risk of serious gastroenteritis : Findings from two perinatal hiv prevention trials in Kampala, Uganda. / Onyango-Makumbi, Carolyne; Bagenda, Danstan; Mwatha, Antony; Omer, Saad B.; Musoke, Philippa; Mmiro, Francis; Zwerski, Sheryl L.; Asiimwe Kateera, Brenda; Musisi, Maria; Fowler, Mary Glenn; Jackson, J. Brooks; Guay, Laura A.
In: Journal of Acquired Immune Deficiency Syndromes, Vol. 53, No. 1, 01.2010, p. 20-27.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Early weaning of hiv-exposed uninfected infants and risk of serious gastroenteritis
T2 - Findings from two perinatal hiv prevention trials in Kampala, Uganda
AU - Onyango-Makumbi, Carolyne
AU - Bagenda, Danstan
AU - Mwatha, Antony
AU - Omer, Saad B.
AU - Musoke, Philippa
AU - Mmiro, Francis
AU - Zwerski, Sheryl L.
AU - Asiimwe Kateera, Brenda
AU - Musisi, Maria
AU - Fowler, Mary Glenn
AU - Jackson, J. Brooks
AU - Guay, Laura A.
PY - 2010/1
Y1 - 2010/1
N2 - OBJECTIVE: To assess serious gastroenteritis risk and mortality associated with early cessation of breastfeeding in infants enrolled in 2 prevention of maternal-to-child HIV-transmission trials in Uganda. METHODS: We used hazard rates to evaluate serious gastroenteritis events by month of age and mortality among HIV-exposed uninfected infants enrolled in the HIV Network for Prevention Trials (HIVNET 012) (1997-2001) and HIV hyperimmune globulin (HIVIGLOB)/nevirapine (NVP) (2004-2007) trials. HIV-infected mothers were counseled using local infant feeding guidelines current at the time. RESULTS: Breastfeeding cessation occurred earlier in HIVIGLOB/NVP compared with HIVNET 012 (median 4.0 versus 9.3 months, P <0.001). Rates of serious gastroenteritis were higher in HIVIGLOB/NVP (8.0/1000 child-months) than in HIVNET 012 (3.1/1000 child-months; P <0.001). Serious gastroenteritis events also peaked earlier at 3-4 and 7-8 months (16.2/1000 and 15.0/1000 child-months, respectively) compared with HIVNET 012 at 9-10 months (20.8/1000 child-months). All cause infant mortality did not statistically differ between the HIVIGLOB/NVP and the HIVNET 012 trials [3.2/1000 versus 2.0/1000 child-months, respectively (P = 0.10)]. CONCLUSIONS: Early breastfeeding cessation seen in the HIVIGLOB/NVP trial was associated with increased risk of serious gastroenteritis among HIV-exposed uninfected infants when compared with later breastfeeding cessation in the HIVNET 012 trial. Testing interventions, which could decrease HIV transmission through breastfeeding and allow safe breastfeeding into the second year of life, are urgently needed.
AB - OBJECTIVE: To assess serious gastroenteritis risk and mortality associated with early cessation of breastfeeding in infants enrolled in 2 prevention of maternal-to-child HIV-transmission trials in Uganda. METHODS: We used hazard rates to evaluate serious gastroenteritis events by month of age and mortality among HIV-exposed uninfected infants enrolled in the HIV Network for Prevention Trials (HIVNET 012) (1997-2001) and HIV hyperimmune globulin (HIVIGLOB)/nevirapine (NVP) (2004-2007) trials. HIV-infected mothers were counseled using local infant feeding guidelines current at the time. RESULTS: Breastfeeding cessation occurred earlier in HIVIGLOB/NVP compared with HIVNET 012 (median 4.0 versus 9.3 months, P <0.001). Rates of serious gastroenteritis were higher in HIVIGLOB/NVP (8.0/1000 child-months) than in HIVNET 012 (3.1/1000 child-months; P <0.001). Serious gastroenteritis events also peaked earlier at 3-4 and 7-8 months (16.2/1000 and 15.0/1000 child-months, respectively) compared with HIVNET 012 at 9-10 months (20.8/1000 child-months). All cause infant mortality did not statistically differ between the HIVIGLOB/NVP and the HIVNET 012 trials [3.2/1000 versus 2.0/1000 child-months, respectively (P = 0.10)]. CONCLUSIONS: Early breastfeeding cessation seen in the HIVIGLOB/NVP trial was associated with increased risk of serious gastroenteritis among HIV-exposed uninfected infants when compared with later breastfeeding cessation in the HIVNET 012 trial. Testing interventions, which could decrease HIV transmission through breastfeeding and allow safe breastfeeding into the second year of life, are urgently needed.
KW - Breastfeeding cessation
KW - HIV
KW - Infants
KW - Mortality
KW - Serious gastroenteritis
KW - Uganda
UR - http://www.scopus.com/inward/record.url?scp=74049112318&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=74049112318&partnerID=8YFLogxK
U2 - 10.1097/QAI.0b013e3181bdf68e
DO - 10.1097/QAI.0b013e3181bdf68e
M3 - Article
C2 - 19779355
AN - SCOPUS:74049112318
VL - 53
SP - 20
EP - 27
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
SN - 1525-4135
IS - 1
ER -