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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Incidence and correlates of hiv-1 rna detection in the breast milk of women receiving haart for the prevention of hiv-1 transmission
PLoS ONE, Volume 7, No. 1, Article e29777, Year 2012
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Description
Background: The incidence and correlates of breast milk HIV-1 RNA detection were determined in intensively sampled women receiving highly active antiretroviral therapy (HAART) for the prevention of mother-to-child HIV-1 transmission. Methods: Women initiated HAART at 34 weeks of pregnancy. Breast milk was collected every 2-5 days during 1 month postpartum for measurements of cell-associated HIV DNA and cell-free HIV RNA. Plasma and breast milk were also collected at 2 weeks, 1, 3 and 6 months for concurrent HIV-1 RNA and DNA measurements. Regression was used to identify cofactors for breast milk HIV-1 RNA detection. Results: Of 259 breast milk specimens from 25 women receiving HAART, 34 had detectable HIV-1 RNA (13%, incidence 1.4 episodes/100 person-days 95% CI = 0.97-1.9). Fourteen of 25 (56%) women had detectable breast milk HIV-1 RNA [mean 2.5 log10 copies/ml (range 2.0-3.9)] at least once. HIV-1 DNA was consistently detected in breast milk cells despite HAART, and increased slowly over time, at a rate of approximately 1 copy/106 cells per day (p = 0.02). Baseline CD4, plasma viral load, HAART duration, and frequency of breast problems were similar in women with and without detectable breast milk HIV-1 RNA. Women with detectable breast milk HIV-1 RNA were more likely to be primiparous than women without (36% vs 0%, p = 0.05). Plasma HIV-1 RNA detection (OR = 9.0, 95%CI = 1.8-44) and plasma HIV-1 RNA levels (OR = 12, 95% CI = 2.5-56) were strongly associated with concurrent detection of breast milk HIV-1 RNA. However, no association was found between breast milk HIV-1 DNA level and concurrent breast milk HIV-1 RNA detection (OR = 0.96, 95%CI = 0.54-1.7). Conclusions: The majority of women on HAART had episodic detection of breast milk HIV-1 RNA. Breast milk HIV-1 RNA detection was associated with systemic viral burden rather than breast milk HIV-1 DNA. © 2012 Slyker et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3256181/bin/pone.0029777.s001.eps
Authors & Co-Authors
Slyker, Jennifer A.
United States, Seattle
University of Washington
Chung, Michael Hoonbae
United States, Seattle
University of Washington
Lehman, Dara A.
United States, Seattle
Fred Hutchinson Cancer Research Center
Kiarie, James Njogu
Kenya, Nairobi
University of Nairobi
Kinuthia, John
Kenya, Nairobi
Kenyatta National Hospital
Holte, Sarah E.
United States, Seattle
University of Washington
Tapia, Kenneth A.
United States, Seattle
University of Washington
Njiri, Francis J.
Kenya, Nairobi
University of Nairobi
Overbaugh, Julie M.
United States, Seattle
Fred Hutchinson Cancer Research Center
John-Stewart, Grace C.
United States, Seattle
University of Washington
Statistics
Citations: 27
Authors: 10
Affiliations: 4
Identifiers
Doi:
10.1371/journal.pone.0029777
e-ISSN:
19326203
Research Areas
Genetics And Genomics
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cohort Study
Participants Gender
Female