@article{fdi:010073051,
  title = {{C}ontribution of maternal antiretroviral therapy and breastfeeding to 24-month survival in human immunodeficiency virus-exposed uninfected children : an individual pooled analysis of {A}frican and {A}sian studies},
  author = {{A}rikawa, {S}. and {R}ollins, {N}. and {J}ourdain, {G}onzague and {H}umphrey, {J}. and {K}ounis, {A}. {P}. and {H}offman, {I}. and {E}ssex, {M}. and {F}arley, {T}. and {C}oovadia, {H}. {M}. and {G}ray, {G}. and {K}uhn, {L}. and {S}hapiro, {R}. and {L}eroy, {V}. and {B}ollinger, {R}. {C}. and {O}nyango-{M}akumbi, {C}. and {L}ockman, {S}. and {M}arquez, {C}. and {D}oherty, {T}. and {D}abis, {F}. and {M}andelbrot, {L}. and {L}e {C}oeur, {S}. and {R}olland, {M}. and {J}oly, {P}. and {N}ewell, {M}. {L}. and {B}ecquet, {R}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground. {H}uman immunodeficiency virus ({HIV})-infected pregnant women increasingly receive antiretroviral therapy ({ART}) to prevent mother-to-child transmission ({PMTCT}). {S}tudies suggest {HIV}-exposed uninfected ({HEU}) children face higher mortality than {HIV}-unexposed children, but most evidence relates to the pre-{ART} era, breastfeeding of limited duration, and considerable maternal mortality. {M}aternal {ART} and prolonged breastfeeding while on {ART} may improve survival, although this has not been reliably quantified. {M}ethods. {I}ndividual data on 19 219 {HEU} children from 21 {PMTCT} trials/cohorts undertaken from 1995 to 2015 in {A}frica and {A}sia were pooled to estimate the association between 24-month mortality and maternal/infant factors, using random-effects {C}ox proportional hazards models. {A}djusted attributable fractions of risks computed using the predict function in the {R} package "frailtypack" were used to estimate the relative contribution of risk factors to overall mortality. {R}esults. {C}umulative incidence of death was 5.5% (95% confidence interval, 5.1-5.9) by age 24 months. {L}ow birth weight ({LBW} <2500 g, adjusted hazard ratio (a{HR}, 2.9), no breastfeeding (a{HR}, 2.5), and maternal death (a{HR}, 11.1) were significantly associated with increased mortality. {M}aternal {ART} (a{HR}, 0.5) was significantly associated with lower mortality. {A}t the population level, {LBW} accounted for 16.2% of 24-month mortality, never breastfeeding for 10.8%, mother not receiving {ART} for 45.6%, and maternal death for 4.3%; combined, these factors explained 63.6% of deaths by age 24 months. {C}onclusions. {S}urvival of {HEU} children could be substantially improved if public health practices provided all {HIV}-infected mothers with {ART} and supported optimal infant feeding and care for {LBW} neonates.},
  keywords = {{HIV}-exposed uninfected ; children, infants ; mortality ; {A}sia ; {A}frica ; {AFRIQUE} {SUBSAHARIENNE} ; {ASIE}},
  booktitle = {},
  journal = {{C}linical {I}nfectious {D}iseases},
  volume = {66},
  numero = {11},
  pages = {1668--1677},
  ISSN = {1058-4838},
  year = {2018},
  DOI = {10.1093/cid/cix1102},
  URL = {https://www.documentation.ird.fr/hor/fdi:010073051},
}