Effect of postnatal HIV treatment on clinical mastitis and breast inflammation in HIV-infected breastfeeding women

Details

• Alternative Title:
  Paediatr Perinat Epidemiol
• Personal Author:
  Zadrozny, Sabrina ; Westreich, Daniel ; Hudgens, Michael G. ; Chasela, Charles ; Jamieson, Denise J. ; Martinson, Francis ; Zimba, Chifundo ; Tegha, Gerald ; Hoffman, Irving ; Miller, William C. ; Pence, Brian W. ; King, Caroline C. ; Kourtis, Athena P. ; Msungama, Wezi ; van der Horst, Charles
• Corporate Authors:
  for the BAN Study Team
• Description:
  Background
  
  The relationship between mastitis and antiretroviral therapy among HIV-positive, breastfeeding 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 24 weeks of exclusive breastfeeding and 4 weeks of weaning. Among 1,472 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, 88 of 1472 women experienced at least one occurrence of mastitis or breast inflammation. The 28-week risk was higher for maternal ART (RD 4.5, 95% confidence interval (CI): 0.9, 8.1) and infant NVP (RD: 3.6, 95%CI: 0.9-6.9) 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 breastfeeding 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.
  
  
• Keywords:
  Adult Anti-HIV Agents Breast Feeding Dietary Supplements Female HIV Infections Humans Malawi Mastitis Postnatal Care Pregnancy Pregnancy Complications, Infectious Risk Factors

  More +
• Source:
  Paediatr Perinat Epidemiol. 31(2):134-143
• Pubmed ID:
  28205255
• Pubmed Central ID:
  PMC6029881
• Document Type:
  Journal Article
• Funding:
  D43 TW001039/TW/FIC NIH HHSUnited States/ ; U48DP001944/ACL HHSUnited States/ ; DP2 HD084070/HD/NICHD NIH HHSUnited States/ ; R25 TW009340/TW/FIC NIH HHSUnited States/ ; R24 TW007988/TW/FIC NIH HHSUnited States/ ; U48DP001944/ACL HHS/ ; U48 DP001944/DP/NCCDPHP CDC HHSUnited States/ ; U48 DP000059/DP/NCCDPHP CDC HHSUnited States/ ; P30 AI050410/AI/NIAID NIH HHSUnited States/
• Volume:
  31
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:c4449811e475a8df75f5f50cfa29e22f4f01f6010b461451c8ae138b739efd59
• Download URL:
  https://stacks.cdc.gov/view/cdc/56652/cdc_56652_DS1.pdf
• File Type:
  [PDF - 221.09 KB ]