Effect of perinatal zidovudine prophylaxis on the evolution of cell-free HIV-1 RNA in breast milk and on postnatal transmission.


Manigart, O; Crepin, M; Leroy, V; Meda, N; Valea, D; Janoff, EN; Rouet, F; Dequae-Merchadoux, L; Dabis, F; Rouzioux, C; Van de Perre, P; Diminution de la Transmission Mere-Enfant Study Group, ; (2004) Effect of perinatal zidovudine prophylaxis on the evolution of cell-free HIV-1 RNA in breast milk and on postnatal transmission. The Journal of infectious diseases, 190 (8). pp. 1422-8. ISSN 0022-1899 DOI: https://doi.org/10.1086/424569

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Abstract

Perinatal zidovudine (ZDV) prophylaxis decreases rates of perinatal transmission of human immunodeficiency virus type 1 (HIV-1). Its relationship with levels of HIV-1 RNA in breast milk and postnatal transmission in breast-fed African children is unknown. At day 8 after delivery, levels of HIV-1 RNA in breast milk from 28 women who transmitted HIV-1 (Ts) postnatally and from 130 women who did not transmit HIV-1 (NTs) were lower for women receiving ZDV than for women receiving placebo. Levels of HIV-1 RNA in breast milk remained low over time in NTs but increased by 8-16-fold in Ts treated with ZDV from baseline to days 45/90 after delivery. Levels of HIV-1 RNA in breast milk at day 8 after delivery and the increase in levels of HIV-1 RNA in breast milk from day 8 to days 45/90 after delivery were independently associated with postnatal transmission. An increase in the levels of HIV-1 RNA in breast milk from day 8 to 45 after delivery was associated with maternal ZDV prophylaxis. The rebound in levels of HIV-1 RNA in breast milk after discontinuation of maternal antiretrovirals needs to be further explored--it may justify prolonging antiretroviral prophylaxis during the entire breast-feeding period.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Disease Control
PubMed ID: 15378434
Web of Science ID: 223968700008
URI: http://researchonline.lshtm.ac.uk/id/eprint/2011

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