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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Temporal reduction of HIV type 1 viral load in breast milk by single-dose nevirapine during prevention of MTCT
AIDS Research and Human Retroviruses, Volume 25, No. 12, Year 2009
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Description
Short-course zidovudine (ZDV) with or without a single dose of nevirapine (sdNVP) is widely used to prevent mother-to-child HIV transmission (PMTCT). However, more data on viral load in breast milk following pMTCT regimens are needed. In a randomized PMTCT study in Botswana, in which half of the women received sdNVP in labor, stored samples from mothers assigned to breastfeed were analyzed for HIV-1 RNA in breast milk supernatant. A total of 527 samples from 282 women, collected at delivery, 2 weeks, 2 months, and 5 months postpartum were available for testing. Cell-free breast milk HIV-1 RNA was detectable (>40copies/ml) in 44.8% (236/527) of samples analyzed. Women randomized to sdNVP+ZDV were more likely to have undetectable breast milk viral loads at 2 weeks postpartum compared with those who received ZDV alone (67.8% vs. 38.5%, p=0.002). By 2 months postpartum the difference between study arms disappeared, and 43.8% of women who received sdNVP+ZDV had undetectable HIV-1 RNA compared to 53.8% of the ZDV alone group (p=0.19) and 60.5% vs. 64.5%, respectively, at month 5 (p=0.61.) The addition of sdNVP to antenatal short-course AZT resulted in significantly reduced breast milk viral loads at 2 weeks postpartum suggesting a reduced risk of MTCT during the early postpartum period. However, viral loads in both study arms were comparable at 2 and 5 months postpartum, suggesting that the receipt of sdNVP in labor may defer rather than blunt the postpartum viral load rebound seen in breast milk after the discontinuation of ZDV. © 2009, Mary Ann Liebert, Inc.
Authors & Co-Authors
Rossenkhan, Raabya
Botswana, Gaborone
University of Botswana
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
Ndung'u, Thumbi P.
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
United States, Boston
Harvard T.h. Chan School of Public Health
Sebunya, Theresa Kibirige
Botswana, Gaborone
University of Botswana
Hagan, José Edward
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
Shapiro, Roger L.
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
United States, Boston
Harvard T.h. Chan School of Public Health
United States, Boston
Beth Israel Deaconess Medical Center
Novitsky, Vladimir A.
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
United States, Boston
Harvard T.h. Chan School of Public Health
Moyo, Sikhulile M.
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
Thior, Ibou
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
United States, Boston
Harvard T.h. Chan School of Public Health
Lockman, Shahin
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
United States, Boston
Harvard T.h. Chan School of Public Health
Mitchell, Rebecca M.
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
Kim, Soyeon
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
United States, Boston
Harvard T.h. Chan School of Public Health
Musonda, Rosemary Mubanga
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
United States, Boston
Harvard T.h. Chan School of Public Health
van Widenfelt, Erik
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
United States, Boston
Harvard T.h. Chan School of Public Health
Makhema, Joseph M.
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
United States, Boston
Harvard T.h. Chan School of Public Health
Essex, Max E.
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
United States, Boston
Harvard T.h. Chan School of Public Health
Statistics
Citations: 15
Authors: 15
Affiliations: 4
Identifiers
Doi:
10.1089/aid.2009.0037
ISSN:
08892229
Research Areas
Infectious Diseases
Maternal And Child Health
Study Locations
Botswana
Participants Gender
Female