Journal
PAEDIATRIC AND PERINATAL EPIDEMIOLOGY
Volume 31, Issue 2, Pages 134-143Publisher
WILEY
DOI: 10.1111/ppe.12337
Keywords
Mastitis; breast-feeding; human immunodeficiency virus; prophylactic antiretroviral therapy; infant nevirapine
Funding
- Prevention Research Centers Special Interest Project of the Centers for Disease Control and Prevention [SIP 13-01 U48-CCU409660-09, SIP 26-04 U48-DP00005901, SIP 22-09 U48-DP001944-01]
- National Institute of Allergy and Infectious Diseases
- University of North Carolina Center for AIDS Research [P30-AI50410]
- NIH Fogarty AIDS International Training and Research Program [2-D43 TW01039-06, R24 TW007988]
- Fogarty Clayton-Dedonder Global Health Mentorship Program [R25TW009340-03S4]
- Abbott Laboratories
- GlaxoSmithKline
- Boehringer Ingelheim
- Roche Pharmaceuticals
- Bristol-Myers Squibb
- Elizabeth Glaser Pediatric AIDS Foundation
- United Nations Children's Fund
- World Food Program
- Malawi Ministry of Health and Population
- Johnson and Johnson
- US Agency for International Development
Ask authors/readers for more resources
Background: The relationship between mastitis and antiretroviral therapy among HIV-positive, breast-feeding women is unclear. Methods: In the Breastfeeding, Antiretrovirals, and Nutrition (BAN) study, conducted in Lilongwe, Malawi, 2369 mother-infant pairs were randomized to a nutritional supplement group and to one of three treatment groups: maternal antiretroviral therapy (ART), infant nevirapine (NVP) or standard of care for 24weeks of exclusive breast-feeding and 4weeks of weaning. Among 1472 HIV-infected women who delivered live infants between 2004 and 2007, we estimated cumulative incidence functions and sub-distribution hazard ratios (HR) of mastitis or breast inflammation comparing women in maternal ART (n = 487) or infant nevirapine (n = 492) groups to the standard of care (n = 493). Nutritional supplement groups (743 took, 729 did not) were also compared. Results: Through 28-weeks post-partum, 102 of 1472 women experienced at least one occurrence of mastitis or breast inflammation. The 28-week risk was higher for maternal ART (risk difference (RD) 4.5, 95% confidence interval (CI) 0.9, 8.1) and infant NVP (RD 3.6, 95% CI 0.3, 6.9) compared to standard of care. The hazard of late-appearing mastitis or breast inflammation (from week 5-28) was also higher for maternal ART (HR 6.7, 95% CI 2.0, 22.6) and infant NVP (HR 5.1, 95% CI 1.5, 17. 5) compared to the standard of care. Conclusions: Mastitis or breast inflammation while breast-feeding is a possible side effect for women taking prophylactic ART and women whose infants take NVP, warranting additional research in the context of postnatal HIV transmission.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available