title: Preventing HIV-1 transmission in breastfed infants in low resource settings: early HIV infection and late postnatal transmission in a routine prevention of mother-to-child transmission program in Yaounde, Cameroon.
abstract: OBJECTIVE
  To report on overall HIV-transmission rates [early and late postnatal transmission (LPNT)] in breastfed infants born to HIV-positive women.
  
  
  METHODS
  Mother-baby pairs in a routine prevention of mother-to-child transmission program. Promotion of exclusive breastfeeding (EBF) coupled with access to antiretroviral treatment (ART) or prevention using antiretroviral (pARV). Early infant diagnosis using HIV-RNA/PCR or HIV-DNA/PCR >6 weeks. LPNT assessed 6 weeks after weaning in infant earlier tested negative.
  
  
  METHODS
  early HIV infection and LPNT.
  
  
  RESULTS
  We included 285 infants for analysis; 89.5 % of mothers were receiving ART or pARV; 86% babies took daily pARV (median duration, 6 weeks). Exclusive breastfeeding (EBF) rate: 96% (median duration, 4 months). The cumulative transmission of HIV-1 was 2.8% at 8 weeks (95% confidence interval: 1.9-3.7). After weaning (abrupt 44%), 3 of 212 infants were HIV infected (1.4%). Nine-month cumulative HIV-transmission rate was 4.2% (1.5-6.9). Incidence of late postnatal HIV infection stood at 1.5/100 child-years of breastfeeding (BF). Cumulative risk of HIV transmission (8 weeks-9 months) was 1%.
  
  
  CONCLUSIONS
  Both promotion of EBF and access to antiretroviral therapy contribute to lower HIV transmission in breastfed infants in low resource settings.
authors.affiliation: National Social Insurance Fund Hospital, Yaounde, Cameroon.
authors.forename: Anne Esther
authors.initials: AE
authors.lastname: Njom Nlend
authors.forename: Chantal
authors.initials: C
authors.lastname: Same Ekobo
authors.forename: Bernadette
authors.initials: B
authors.lastname: Bagfegue Ekani
authors.forename: Jeannette
authors.initials: J
authors.lastname: Epée Ngoue
authors.forename: Suzie
authors.initials: S
authors.lastname: Tetang Ndiang
authors.forename: Fabrice
authors.initials: F
authors.lastname: Tchinde Toussi
authors.forename: Guillaume
authors.initials: G
authors.lastname: Wamba
authors.forename: Tetanye
authors.initials: T
authors.lastname: Ekoe
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001942:Breast Feeding; D002163:Cameroon / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D015497:HIV-1; D006297:Health Services Accessibility; D006801:Humans; D015994:Incidence; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D009035:Mothers; D049590:Postpartum Period; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D015397:Program Evaluation; D011446:Prospective Studies; D013997:Time Factors; D014886:Weaning
chemical_list: D019380:Anti-HIV Agents
keywords: HIV; breastfeeding; prevention