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首页> 外文期刊>JAIDS: Journal of acquired immune deficiency syndromes >Reduced mortality associated with breast-feeding-acquired HIV infection and breast-feeding among HIV-infected children in Zambia.
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Reduced mortality associated with breast-feeding-acquired HIV infection and breast-feeding among HIV-infected children in Zambia.

机译：与赞比亚通过母乳喂养获得的HIV感染以及在被HIV感染的儿童中母乳喂养相关的死亡率降低。

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OBJECTIVES: In developing countries, where mother-to-child transmission of HIV through breast-feeding is common, little is known about the impact of postpartum transmission on child survival. This study assessed whether children infected postpartum have longer survival from time of infection versus those infected during gestation or delivery. DESIGN: We used a prospective cohort study to analyze data from 213 HIV-infected children enrolled in a breast-feeding intervention trial in Lusaka, Zambia (2001 to 2004). METHODS: We compared mortality 1 year after HIV infection in children stratified by age of infection: 0 to 3 days (intrauterine [IU] group), 4 to 40 days (intrapartum/early postpartum [IP/EPP] group), and >40 days (postpartum [PP] group). RESULTS: A total of 61, 71, and 81 children were infected in the IU, IP/EPP, and PP groups, respectively. Children with intrauterine or intrapartum/early postpartum transmission had higher mortality over the first 12 months after infection than children with postpartum transmission (P = 0.001 and P = 0.006, respectively); no differences were detected between children with intrauterine and intrapartum/early postpartum transmission. Nearly 20% of the IU and IP/EPP groups died by 100 days after infection, whereas nearly 10% of the PP group had died by this time. After adjusting for birth weight, maternal CD4 cell count, breast-feeding, and maternal death, children infected postpartum had one quarter the mortality rate (hazard ratio [HR] = 0.27, 95% confidence interval [CI]: 0.15 to 0.50) of those infected in utero. Stopping breast-feeding increased mortality in infected children (HR = 3.1, 95% CI: 1.8 to 5.3). CONCLUSIONS: This study demonstrates a survival benefit among children infected postpartum versus children infected during pregnancy or delivery and a benefit to increased breast-feeding duration among infected children. Testing children for HIV early may provide a means to allow for earlier intervention.
机译：目的：在发展中国家，通过母乳喂养艾滋病毒母婴传播很普遍，对于产后传播对儿童生存的影响知之甚少。这项研究评估了感染后的孩子从妊娠到感染或分娩相比是否具有更长的生存期。设计：我们使用一项前瞻性队列研究来分析来自赞比亚卢萨卡（2001年至2004年）的213名接受母乳喂养干预试验的HIV感染儿童的数据。方法：我们比较了按感染年龄分层的儿童感染HIV后1年的死亡率：0至3天（宫内[IU]组），4至40天（产前/产后早期[IP / EPP]组）和> 40天（产后[PP]组）。结果：IU，IP / EPP和PP组分别感染了61、71和81名儿童。宫腔内或产后/产后早期传播的儿童在感染后的前12个月死亡率高于产后传播的儿童（分别为P = 0.001和P = 0.006）;在宫内和产后/产后早期传播的儿童之间未发现差异。感染后100天，IU和IP / EPP组中将近20％死亡，而此时PP组中已将近10％死亡。在调整出生体重，母亲CD4细胞计数，母乳喂养和母亲死亡后，感染后的儿童的产后死亡率为四分之一（危险比[HR] = 0.27，95％置信区间[CI]：0.15至0.50）那些在子宫内感染的人。停止母乳喂养会增加感染儿童的死亡率（HR = 3.1，95％CI：1.8至5.3）。结论：这项研究表明，相比于怀孕或分娩期间感染的儿童，产后感染的儿童具有生存优势，而受感染的儿童的母乳喂养时间更长。尽早对儿童进行艾滋病毒检测可能会提供一种手段，允许早期干预。

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