Effect of Postnatal HIV Treatment on Clinical Mastitis and Breast Inflammation in HIV-Infected Breast-feeding Women.
Paediatr Perinat Epidemiol
; 31(2): 134-143, 2017 Mar.
Article
in En
| MEDLINE
| ID: mdl-28205255
ABSTRACT
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 24 weeks of exclusive breast-feeding and 4 weeks 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.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Pregnancy Complications, Infectious
/
Breast Feeding
/
HIV Infections
/
Anti-HIV Agents
/
Mastitis
Type of study:
Clinical_trials
/
Etiology_studies
/
Risk_factors_studies
Country/Region as subject:
Africa
Language:
En
Journal:
Paediatr Perinat Epidemiol
Year:
2017
Type:
Article