Effect of Postnatal HIV Treatment on Clinical Mastitis and Breast Inflammation in HIV-Infected Breast-feeding Women.
Journal Article (Journal Article)
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.
Full Text
Duke Authors
Cited Authors
- Zadrozny, S; Westreich, D; Hudgens, MG; Chasela, C; Jamieson, DJ; Martinson, F; Zimba, C; Tegha, G; Hoffman, I; Miller, WC; Pence, BW; King, CC; Kourtis, AP; Msungama, W; van der Horst, C; BAN Study Team,
Published Date
- March 2017
Published In
Volume / Issue
- 31 / 2
Start / End Page
- 134 - 143
PubMed ID
- 28205255
Pubmed Central ID
- PMC6029881
Electronic International Standard Serial Number (EISSN)
- 1365-3016
Digital Object Identifier (DOI)
- 10.1111/ppe.12337
Language
- eng
Conference Location
- England