[63] MORTALITY IN BREAST-FED AND FORMULA-FED CHILDREN BORN TO HIVINFECTED WOMEN IN A PMTCT PROJECT IN ABIDJAN (COTE D'IVOIRE): DITRAME PLUS ANRS 1202

2nd International AIDS Society Conference on HIV Pathogenesis and Treatment

Paris, France - July 13 - 16, 2003

[TITLE:] MORTALITY IN BREAST-FED AND FORMULA-FED CHILDREN BORN TO HIVINFECTED WOMEN IN A PMTCT PROJECT IN ABIDJAN (COTE D'IVOIRE): DITRAME PLUS ANRS 1202

[AUTHOR(S):] R Becquet¹, L Becquet², DK Ekouevi¹,², I Viho², H Toure², F Dabis¹, M Timite-Konan³ and V Leroy¹
¹ Unite INSERM 593, Universite Victor Segalen, Bordeaux, France; ² ANRS Ditrame Plus project, PACCI Program, Abidjan, Cote d'Ivoire; and ³ University Hospital (CHU) of Yopougon, Abidjan, Cote d'Ivoire

IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd: Abstract No. 63
Antiviral Therapy 2003; 8(Suppl. 1):S200

[ABSTRACT:] Background: To describe mortality according to their initial feeding practice (breastfeeding or formula-feeding) among children born to HIV-infected mothers, in a Prevention of Mother-to-Child Transmission of HIV (PMTCT) project in Abidjan, Cote d'Ivoire.

Methods: Between March 2001 and August 2002, any HIV-1 infected pregnant woman, age ≥18, who accepted pre- and post-test counselling and who received a perinatal PMTCT antiretroviral intervention (zidovudine and nevirapine) was eligible if she gave a live-birth. Two infant feeding interventions were systematically proposed: formula-feeding (free of charge) from birth with a drug inhibiting lactation or exclusive breast-feeding during 3 months then early cessation of breast-feeding. Mother-infant pairs were closely followed during 2 years, with a paediatric HIV-diagnosis, counselling, and collection of the feeding practices at each visit.

Results: From March 2001 to February 2003, 398 live-born children were enrolled. Among the 393 children fed at least once, 201 (51.2%) received formula-feeding from birth for a median of 215 days before any nutritional switch, 175 (44.5%) were breast-fed from birth for 123 days and 17 (4.3%) were mixed-fed. Death occurred in 28 children among whom 11 were HIV-infected at age 6 weeks. Among HIV-uninfected children fed at least once, four and two deaths occurred between birth and the first nutritional switch in the formula-fed (n=187) and breastfed (n=166) children, respectively, yielding an incidence mortality rate of 30.4‰ (95% CI: 8.3.77.0) and 34.2‰ (95% CI: 4.1.123.5), respectively.

Conclusions: In this context of an intensive counselling from birth, there is no evidence of a higher mortality in formula-fed HIV-uninfected children compared to those breast-fed. Further follow-up will allow us to compare these mortality rates with those in the general population in Abidjan.

030714
63