AEGiS-13IAC: Method of feeding and transmission of HIV-1 from mothers to children by 15 months of age: prospective cohort study from Durban.

13th International AIDS Conference


Durban, South Africa - July 9-July 14, 2000

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Method of feeding and transmission of HIV-1 from mothers to children by 15 months of age: prospective cohort study from Durban.

Int Conf AIDS 2000 Jul 9-14; 13:17 (abstract no.. LbOr6)

Coutsoudis A
University of Natal, Congella, South Africa. Fax: +27-31-2604388, E-mail: coutsoud@med.und.ac.za.

BACKGROUND: Risk of mother to child transmission (MTCT) of HIV-1 through breastfeeding has not previously been examined in the light of the pattern of breastfeeding. We present the completed results (up to 15 months) of the effect of exclusive breastfeeding vs mixed breastfeeding.

METHODS: Following counselling, women self-selected to breastfeed or formula feed. Breastfeeders were counselled and supported to practice exclusive breastfeeding for 6 months.

RESULTS: Of 728 HIV-seropositive women recruited, 551 mother-baby pairs were included for study. 157(28.5%) were never breastfed and 394 (71.5%) were breastfed. Breastfeeders were separated into 118 who exclusively breastfed to 3 months or more and 276 who mixed breastfed. The 3 feeding groups did not differ in any risk factors for MTCT and the probability of detecting HIV at birth was similar. The cumulative probabilities of HIV infection remained similar among never and exclusive breastfeeders up to 6 months 0.194 (95% CI: 0.131-0.256) and 0.194 (95% CI 0.119-0.269) respectively, whereas the probabilities among mixed breastfeeders soon surpassed both groups reaching 0.261 (95% CI 0.203-0.318) by 6 months. By 15 months the cumulative probability of HIV infection still remained lower among those who exclusively breastfed for 3 months (or more) than among other breastfeeders (0.247 vs 0.359.

CONCLUSIONS: These longer term data support our early report that exclusive breastfeeding for 3 months lowers risk of MTCT of HIV compared to mixed breastfeeding. Infants exclusively breastfed for at least 3 months and up to 6 months have no excess risk of HIV infection over those never breastfed. These findings, if confirmed elsewhere, can influence public health policies on feeding choices available to HIV infected mothers in developing countries.

Keywords: AEGIS, HIV-1, Breast Feeding, Mothers, Cohort Studies, Prospective Studies, HIV Infections, Bottle Feeding, Risk Factors, HIV Seropositivity, Developing Countries, Counseling, Child, Human, Female, Infant, transmission, methods, therapy, AIDSKWDaegis,hiv-1,breastfeeding,mothers,cohortstudies,prospectivestudies,hivinfections,bottlefeeding,riskfactors,hivseropositivity,developingcountries,counseling,child,human,female,infant,transmission,methods,therapy,aids
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