AEGiS-13IAC: Changes in breast milk and plasma HIV-1 viral load during the first 6 weeks postpartum in HIV-infected women recieving short-course oral zidovudine in Abidjan, Cote d'Ivoire.

13th International AIDS Conference

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

Changes in breast milk and plasma HIV-1 viral load during the first 6 weeks postpartum in HIV-infected women recieving short-course oral zidovudine in Abidjan, Cote d'Ivoire.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. WeOrC493)

Krou-Danho N, Sibailly TS, Bertolli J, Boni-Ouattara E, Ekpini ER, Nkengasong J, Maurice C, Monga B, Roels TH, Greenberg AE, Wiktor SZ
N. Krou-Danho, Projekt RETRO-CI, 01 BP 1712, Abidjan, Cote D'ivoire, Tel.: +225 212 541 11, Fax: +225 212 429 69, E-mail: ned0@cdc.gov

OBJECTIVES: To describe changes in HIV-1 viral load in breast milk (BMVL) and plasma (PVL) during the first 6 weeks postpartum in women receiving short-course zidovudine (ZDV).

METHODS: From December 1998 to December 1999, all consenting HIV-1 seropositive women attending a public prenatal clinic were enrolled at 36 weeks of gestation and received a short-course regimen of ZDV to prevent mother-to-child transmission of HIV-1. For all breast-feeding women, paired blood and breast milk specimens were collected weekly during the first 6 weeks postpartum. HIV-1 RNA was quantified (log₁₀ copies/ml) in plasma and breast milk using the Amplicor Monitor test (Roche). Statistical analysis was done using the Wald statistic (time variation within PVL and BMVL) and the Pearson statistic (correlation between PVL and BMVL).

RESULTS: n Median (IQR) HIV-1 BMVL Median (IQR) HIV-1 PVL p (Pearson) Birth 17 2.43 (2.30-2.99) 3.51 (2.52-4.18) 0.0147 1 week 47 2.31 (2.30-3.01) 4.17 (3.52-4.99) 0.0001 2 weeks 47 2.94 (2.30-3.97) 4.61 (3.83-5.12) 0.0001 3 weeks 46 3.20 (2.30-3.94) 4.53 (3.55-5.05) 0.0001 4 weeks 41 2.91 (2.30-3.51) 4.43 (3.62-4.91) 0.0001 5 weeks 39 2.62 (2.30-3.36) 4.38 (3.90-4.89) 0.0003 6 weeks 42 2.51 (2.30-3.20) 4.37 (3.55-4.96) 0.0001 p (Wald chi square) 0.0003 0.0003

CONCLUSION: Significant variations in BMVL and PVL occur during the first 6 weeks postpartum, with a peak occurring at 2-3 weeks postpartum. It is important to assess whether this increase is a result of maternal ZDV use and whether it raises the risk of postnatal transmission of HIV-1.

Keywords: AEGIS, Zidovudine, Viral Load, HIV-1, HIV, HIV Infections, Milk, Human, HIV Seropositivity, Anti-HIV Agents, Breast Feeding, Plasma, Puerperium, Cote d'Ivoire, Mothers, Human, Female, Child
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WeOrC493