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首页> 外文期刊>AIDS >Breastfeeding with maternal antiretroviral therapy or formula feeding to prevent HIV postnatal mother-to-child transmission in Rwanda.
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Breastfeeding with maternal antiretroviral therapy or formula feeding to prevent HIV postnatal mother-to-child transmission in Rwanda.

机译：卢旺达母乳喂养和母亲抗逆转录病毒疗法或配方奶喂养可以防止艾滋病毒在产后母婴传播。

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OBJECTIVE: To assess the 9-month HIV-free survival of children with two strategies to prevent HIV mother-to-child transmission. DESIGN: Nonrandomized interventional cohort study. SETTING: Four public health centres in Rwanda. PARTICIPANTS: Between May 2005 and January 2007, all consenting HIV-infected pregnant women were included. INTERVENTION: Women could choose the mode of feeding for their infant: breastfeeding with maternal HAART for 6 months or formula feeding. All received HAART from 28 weeks of gestation. Nine-month cumulative probabilities of HIV transmission and HIV-free survival were determined using the Kaplan-Meier method and compared using the log-rank test. Determinants were analysed using a Cox model analysis. RESULTS: Of the 532 first-liveborn infants, 227 (43%) were breastfeeding and 305 (57%) were formula feeding. Overall, seven (1.3%) children were HIV-infected of whom six were infected in utero. Only one child in the breastfeeding group became infected between months 3 and 7, corresponding to a 9-month cumulative risk of postnatal infection of 0.5% [95% confidence interval (CI) 0.1-3.4%; P = 0.24] with breastfeeding. Nine-month cumulative mortality was 3.3% (95% CI 1.6-6.9%) in the breastfeeding arm group and 5.7% (95% CI 3.6-9.2%) for the formula feeding group (P = 0.20). HIV-free survival by 9 months was 95% (95% CI 91-97%) in the breastfeeding group and 94% (95% CI 91-96%) for the formula feeding group (P = 0.66), with no significant difference in the adjusted analysis (adjusted hazard ratio for breastfeeding: 1.2 (95% CI 0.5-2.9%). CONCLUSION:: Maternal HAART while breastfeeding could be a promising alternative strategy in resource-limited countries.
机译：目的：通过两种预防艾滋病毒母婴传播的策略，评估儿童的9个月无艾滋病毒存活率。设计：非随机干预队列研究。地点：卢旺达的四个公共卫生中心。参加者：在2005年5月至2007年1月之间，纳入了所有同意的HIV感染孕妇。干预措施：妇女可以选择婴儿的喂养方式：母体HAART母乳喂养6个月或配方奶喂养。所有人从妊娠28周开始接受HAART。使用Kaplan-Meier方法确定了9个月HIV传播和无HIV存活的累积概率，并使用对数秩检验进行比较。行列式使用Cox模型分析进行分析。结果：在532名初生婴儿中，有227名（43％）进行母乳喂养，有305名（57％）进行配方奶喂养。总体而言，有7名（1.3％）儿童被HIV感染，其中有6名在子宫内被感染。母乳喂养组中只有一个孩子在第3个月到第7个月之间被感染，相当于出生后9个月的累积感染风险为0.5％[95％置信区间（CI）0.1-3.4％; P = 0.24]。母乳喂养组的九个月累积死亡率为3.3％（95％CI 1.6-6.9％），配方奶喂养组为5.7％（95％CI 3.6-9.2％）（P = 0.20）。母乳喂养组的9个月无HIV生存率为95％（95％CI 91-97％），配方奶喂养组为94％（95％CI 91-96％）（P = 0.66），无显着差异在调整后的分析中（调整后的母乳喂养危险比：1.2（95％CI 0.5-2.9％））结论：母乳喂养母亲HAART在资源有限的国家可能是一种有希望的替代策略。

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