Maternal Highly Active Antiretroviral Therapy and Child HIV-Free Survival in Malawi, 2004–2009

Sheree Schwartz, Newton Kumwenda, Johnstone Kumwenda, Shu Chen, Lynne M. Mofenson, Allan W. Taylor, Mary Glenn Fowler, Taha E Taha

Research output: Contribution to journalArticle

Abstract

Objectives Highly active antiretroviral therapy (HAART) provision to eligible HIV-infected pregnant and post-partum women is critical for optimizing maternal health. We assessed the impact of maternal HAART on HIV-free survival of breastfed infants in Malawi. Methods The post-exposure prophylaxis of infants-Malawi trial (2004–2009) enrolled mothers/infants during labor or immediately post-partum to evaluate 14-week extended infant antiretroviral prophylaxis for preventing HIV transmission through breastfeeding. Mothers meeting national HAART guidelines were referred for therapy. Child HIV-free survival—survival without HIV infection—was compared by maternal HAART status. Results Overall, 3022 mother-infant pairs contributed 4214 infant/person-years (PY) at-risk for HIV infection or death, with 532 events (incidence 12.6/100 PY, 95 % confidence interval [CI] 11.6–13.7). During follow-up, 349 mothers were HAART initiated; 581 remained HAART naïve with CD4 cell counts 3, and 2092 were never HAART-eligible. By 3 months, 11 % of infants with HAART naïve mothers (CD4 

Original languageEnglish (US)
Pages (from-to)542-549
Number of pages8
JournalMaternal and Child Health Journal
Volume20
Issue number3
DOIs
StatePublished - Mar 1 2016

Fingerprint

Malawi
Highly Active Antiretroviral Therapy
Mothers
HIV
Survival
Post-Exposure Prophylaxis
CD4 Lymphocyte Count
Breast Feeding
HIV Infections
Guidelines
Confidence Intervals
Incidence

Keywords

  • Breastfeeding
  • Child survival
  • Highly active antiretroviral therapy
  • HIV-1
  • Prevention of mother-to-child transmission

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Epidemiology
  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health

Cite this

Maternal Highly Active Antiretroviral Therapy and Child HIV-Free Survival in Malawi, 2004–2009. / Schwartz, Sheree; Kumwenda, Newton; Kumwenda, Johnstone; Chen, Shu; Mofenson, Lynne M.; Taylor, Allan W.; Fowler, Mary Glenn; Taha, Taha E.

In: Maternal and Child Health Journal, Vol. 20, No. 3, 01.03.2016, p. 542-549.

Research output: Contribution to journalArticle

Schwartz, Sheree ; Kumwenda, Newton ; Kumwenda, Johnstone ; Chen, Shu ; Mofenson, Lynne M. ; Taylor, Allan W. ; Fowler, Mary Glenn ; Taha, Taha E. / Maternal Highly Active Antiretroviral Therapy and Child HIV-Free Survival in Malawi, 2004–2009. In: Maternal and Child Health Journal. 2016 ; Vol. 20, No. 3. pp. 542-549.
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