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Extended use of infant prophylaxis during breastfeeding reduces risk of HIV infection by over 70%.

Recent findings from five randomised trials in the US, Ethiopia, India, Uganda and Malawi show that extended use of nevirapine or zidovudine plus nevirapine in breastfeeding infants can reduce the risks of HIV transmission through breastmilk by 71%. Data from these studies were pooled to estimate the effectiveness of infant nevirapine prophylaxis in preventing breastmilk HW transmission in infants who were HIV-negative at birth. A total of 5,396 mother-infant pairs received a range of regimens. The pooled analysis compared the regimens and found that the longer the duration of prophylaxis, the greater the reduction in the risk of infection. The estimated cumulative risk of HW infection among infants uninfected at birth was 5.8% for the six-week, 3.7% for the 14-week nevirapine alone, 4.8% for the 14-week dual-prophylaxis regimen and 1.8% for the 28-week nevirapine regimen. Women with lower CD4 cell counts (between

200 and 350) had a two-fold higher rate of their infants becoming infected than those with higher CD4 cell counts. In addition the more the infant weighed at birth, the less likely it was to become infected. (1)

(1.) Hudgens M, Taha T, Omer SB, et al. Pooled individual data analysis of five randomised trials of infant nevirapine prophylaxis to prevent HIV-1 transmission through breastmilk. Sixth IAS Conference on HIV Pathogenesis, Treatment and Prevention, Rome, 2011. Abstract WELBC03.

DOI: 10.1016/S0968-8080(11)38588-6

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Title Annotation:ROUND UP: HIV and AIDS
Publication:Reproductive Health Matters
Article Type:Brief article
Date:Nov 1, 2011
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