%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Cames, Cécile
%A Cournil, Amandine
%A de Vincenzi, I.
%A Gaillard, P.
%A Meda, N.
%A Luchters, S.
%A Nduati, R.
%A Naidu, K.
%A Newell, M. L.
%A Read, J. S.
%A Bork, Kirsten
%T Postpartum weight change among HIV-infected mothers by antiretroviral prophylaxis and infant feeding modality in a research setting
%D 2014
%L fdi:010061398
%G ENG
%J Aids
%@ 0269-9370
%K Africa ; antiretroviral prophylaxis ; body weight change ; breastfeeding ; HIV infection ; overweight
%K AFRIQUE SUBSAHARIENNE ; BURKINA FASO ; KENYA ; AFRIQUE DU SUD
%M ISI:000328818400010
%N 1
%P 85-94
%R 10.1097/01.aids.0000433243.24481.c3
%U https://www.documentation.ird.fr/hor/fdi:010061398
%> https://www.documentation.ird.fr/intranet/publi/2014/01/010061398.pdf
%V 28
%W Horizon (IRD)
%X Objective:To assess the relationship between infant feeding, triple-antiretroviral prophylaxis and weight from 2 weeks (baseline) to 6 months postpartum among HIV-infected mothers in a mother-to-child transmission (MTCT) of HIV-prevention trial in five sub-Saharan African sites.Methods:HIV-infected pregnant women with CD4(+) cell counts of 200-500cells/l were counselled to choose breastfeeding to 6 months or replacement feeding from delivery. They were randomized to receive perinatal zidovudine and single-dose nevirapine or triple-antiretroviral MTCT prophylaxis until breastfeeding cessation. Mixed-effect linear models were used to compare maternal weight trajectories over time by infant feeding mode. Antiretroviral prophylaxis and BMI at baseline were examined as potential effect modifiers.Results:Among 797 mothers, 620 (78%) initiated breastfeeding. Wasting (BMI <18.5) was rare at baseline (2%), whereas overweight/obesity (BMI25) was common (40%). In the model including all women, breastfeeding was not associated with weight loss up to 6 months, irrespective of baseline BMI and antiretroviral prophylaxis. Triple-antiretroviral prophylaxis was associated with weight gain among replacement-feeding mothers with baseline BMI at least 25 (+0.54kg/month; P<0.0001). In the model including breastfeeding mothers only, triple-antiretroviral prophylaxis was associated with weight gain among mothers with baseline BMI at least 25 who ceased breastfeeding before 3 months postpartum (+0.33kg/month; P=0.03).Conclusion:The results suggest that breastfeeding up to 6 months postpartum is not detrimental for postpartum weight among well nourished HIV-infected mothers at intermediate-disease stage. In the absence of breastfeeding or after weaning, triple-antiretroviral prophylaxis is associated with weight gain among women with high BMI, even after cessation of prophylaxis.
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