Late postnatal transmission of HIV-1 and associated factors.
BACKGROUND
The present study was undertaken to determine the risk and timing of late postnatal transmission (LPT) of human immunodeficiency virus type 1 (HIV-1).


METHODS
Breast-fed infants previously enrolled in 2 trials of antiretroviral prophylaxis were monitored in Malawi. Kaplan-Meier and proportional hazard models assessed cumulative incidence and association of factors with LPT.


RESULTS
Overall, 98 infants were HIV infected, and 1158 were uninfected. The cumulative risk of LPT at age 24 months was 9.68% (95% confidence interval, 7.80%-11.56%). The interval hazards at 1.5-6, 6-12, 12-18, and 18-24 months were 1.22%, 4.05%, 3.48%, and 1.27%, respectively.


CONCLUSIONS
The risk of LPT beyond 6 months is substantial. Weaning at 6 months could prevent >85% of LPT.
Taha
Taha E
TE
Department of Epidemiology, Bloomberg School of Public Health, Baltimore, MD 21205, USA. ttaha@jhsph.edu
Hoover
Donald R
DR
Kumwenda
Newton I
NI
Fiscus
Susan A
SA
Kafulafula
George
G
Nkhoma
Chiwawa
C
Chen
Shu
S
Piwowar
Estelle
E
Broadhead
Robin L
RL
Jackson
J Brooks
JB
Miotti
Paolo G
PG
D001942:Breast Feeding; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008295:Malawi; D008895:Milk, Human / Q000821:virology; D019829:Nevirapine / Q000627:therapeutic use; D012367:RNA, Viral / Q000032:analysis; D012307:Risk Factors; D013997:Time Factors; D015215:Zidovudine / Q000627:therapeutic use
D012367:RNA, Viral; D015215:Zidovudine; D019829:Nevirapine