@article{fdi:010063966,
  title = {{E}arly infant feeding patterns and {HIV}-free survival findings from the {K}esho-{B}ora trial ({B}urkina {F}aso, {K}enya, {S}outh {A}frica)},
  author = {{C}ournil, {A}mandine and {V}an de {P}erre, {P}. and {C}ames, {C}{\'e}cile and de {V}incenzi, {I}. and {R}ead, {J}. {S}. and {L}uchters, {S}. and {M}eda, {N}. and {N}aidu, {K}. and {N}ewell, {M}. {L}. and {B}ork, {K}irsten},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjective: {T}o investigate the association between feeding patterns and {HIV}-free survival in children born to {HIV}-infected mothers and to clarify whether antiretroviral ({ARV}) prophylaxis modifies the association. {M}ethods: {F}rom {J}une 2005 to {A}ugust 2008, {HIV}-infected pregnant women were counseled regarding infant feeding options, and randomly assigned to triple-{ARV} prophylaxis (triple {ARV}) until breastfeeding cessation ({BFC}) before age 6 months or antenatal zidovudine with single-dose nevirapine (short-course {ARV}). {E}ighteen-month {HIV}-free survival of infants {HIV}-negative at 2 weeks of age was assessed by feeding patterns (replacement feeding from birth, {BFC} <3 months, {BFC} >= 3 months). {R}esults: {O}f the 753 infants alive and {HIV}-negative at 2 weeks, 28 acquired infection and 47 died by 18 months. {O}verall {HIV}-free survival at 18 months was 0.91 [95% confidence interval ({CI}): 0.88-0.93]. {I}n the short-course {ARV} arm, {HIV}-free survival (0.88; {CI}: 0.84-0.91) did not differ by feeding patterns. {I}n the triple {ARV} arm, overall {HIV}-free survival was 0.93 ({CI}: 0.90-0.95) and {BFC} <3 months was associated with lower {HIV}-free survival than {BFC} >= 3 months (adjusted hazard ratio: 0.36; {CI}: 0.15-0.83) and replacement feeding (adjusted hazard ratio: 0.20; {CI}: 0.04-0.94). {I}n the triple {ARV} arm, 4 of 9 transmissions occurred after reported {BFC} (and 5 of 19 in the short-course arm), indicating that some women continued breastfeeding after interruption of {ARV} prophylaxis. {C}onclusions: {I}n resource-constrained settings, early weaning has previously been associated with higher infant mortality. {W}e show that, even with maternal triple-{ARV} prophylaxis during breastfeeding, early weaning remains associated with lower {HIV}-free survival, driven in particular by increased mortality.},
  keywords = {infant ; {HIV}-free survival ; prevention of mother-to-child transmission ; breastfeeding ; antiretroviral therapy ; {A}frica ; {BURKINA} {FASO} ; {KENYA} ; {AFRIQUE} {DU} {SUD}},
  booktitle = {},
  journal = {{P}ediatric {I}nfectious {D}isease {J}ournal},
  volume = {34},
  numero = {2},
  pages = {168--174},
  ISSN = {0891-3668},
  year = {2015},
  DOI = {10.1097/inf.0000000000000512},
  URL = {https://www.documentation.ird.fr/hor/fdi:010063966},
}