title: Exclusive Breast-feeding Protects against Mother-to-Child Transmission of HIV-1 through 12 Months of Age in Tanzania.
abstract: The jury on transmission of HIV through breast-feeding is still on. Data from a clinical trial in children born to HIV-positive mothers were evaluated with respect to their relationship to mother-to-child transmission. A total of 1629 infants who were not infected at age 6 weeks, had HIV results available at 12 months and who were breast-fed were included in this study. Exclusive breast feeding (EBF) rates declined from 85% at 2 months to < 30% by 4 months. EBF was associated with a sustained and significant reduction in HIV infection. With every incremental month of EBF, HIV infection was reduced by 16% [multivariable (risk ratio) RR: 0.84, CI: 0.72-0.98, p = 0.03] from enrollment to 6 months of age and by 18% (multivariable RR: 0.82, CI: 0.72-0.94, p = 0.005) from enrollment to 12 months of age. EBF significantly reduces the risk of vertical HIV transmission through 12 months of age.
authors.affiliation: Department of Paediatrics and Child Health, Muhimbili University of Health and Allied Sciences (MUHAS), Dar-es-Salaam, Tanzania kpmanji@gmail.com.
authors.forename: Karim P
authors.initials: KP
authors.lastname: Manji
authors.affiliation: Departments of Nutrition and Global Health and Population, Harvard T.H. Chan School of Public Health/Department of Gastroenterology, Boston Children's Hospital Harvard Medical School, Boston, MA, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Duggan
authors.affiliation: Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Enju
authors.initials: E
authors.lastname: Liu
authors.affiliation: Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Bosch
authors.affiliation: Department of Paediatrics and Child Health, Muhimbili University of Health and Allied Sciences (MUHAS), Dar-es-Salaam, Tanzania.
authors.forename: Rodrick
authors.initials: R
authors.lastname: Kisenge
authors.affiliation: Department of Microbiology and Immunology, MUHAS, Dar-es-Salaam, Tanzania.
authors.forename: Said
authors.initials: S
authors.lastname: Aboud
authors.affiliation: Departments of Nutrition and Global Health and Population, Harvard T.H. Chan School of Public Health/Department of Gastroenterology, Boston Children's Hospital Harvard Medical School, Boston, MA, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Kupka
authors.affiliation: Departments of Global Health and Population, Nutrition, and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Wafaie W
authors.initials: WW
authors.lastname: Fawzi
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001942:Breast Feeding / Q000706:statistics & numerical data*; D004311:Double-Blind Method; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D019259:Lamivudine / Q000627:therapeutic use*; D008297:Male; D008895:Milk, Human / Q000821:virology*; D009035:Mothers; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D013636:Tanzania
chemical_list: D019380:Anti-HIV Agents; D019259:Lamivudine
keywords: Exclusive Breast Feeding, HIV and PMTCT