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Breastfeeding does not contribute to mortality among HIV-positive women in Kenya.

A prospective cohort study comparing 198 HIV positive Kenyan women who breastfed and 98 who formula-fed found no increased risk of overall mortality after two years. But the breastfeeding women had faster CD4 and body mass index declines. In a previous randomised clinical trial breastfeeding mothers did have an increased risk of mortality compared to those who formula-fed. Then, four subsequent African cohort studies found no increased risk. The women in this latest study were not randomised. The women differed as regards education level, access to flush toilets and experience of HIV-related illnesses. But they were similar in median age (25), were mostly married, and had similar viral loads and CD4 counts at baseline (32 weeks of pregnancy). Over the two-year follow-up, there were 12 deaths (6%) in breastfeeding women, eight related to HIV, and four (4%) in women who formula-fed. Risk of death was related to CD4 count but not feeding method, (1) The preponderance of evidence is that HIV-positive women are not compromised by breastfeeding and as formula-fed infants are more likely to die of causes other than HIV, replacement feeding has not reduced the overall risk of infant mortality. (2)

(1.) Otieno PA, et al. HIV-1 disease progression in breastfeeding and formula-feeding mothers: a prospective 2-year comparison of T cell subsets, HIV-RNA levels, and mortality. Journal of Infectious Diseases 2007;195:220-29.

(2.) Wilfert CM, Fowler MG. Balancing maternal and infant benefits and the consequences of breastfeeding in the developing world during the era of HIV infection. Journal of Infectious Diseases 2007;195: 165-67. Summary of both articles by D Thaczuk, 10 January 2007 at: <www.aidsmap.com/en/news/ F2784693-8CA7-44F6-B490-78FOCC388254.asp>.
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Title Annotation:ROUND UP: HIV/AIDS
Publication:Reproductive Health Matters
Article Type:Brief article
Geographic Code:6KENY
Date:May 1, 2007
Words:275
Previous Article:Reduction in perinatal transmission of HIV.
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