Infant Neutropenia Associated with Breastfeeding During Maternal Antiretroviral Treatment for Prevention of Mother-to-Child Transmission of HIV

Maternal antiretroviral treatment (ART) is recommended for prevention of mother-to-child HIV-1 transmission (PMTCT), including in women with high CD4 cell counts. Within a pediatric HIV-1 vaccine trial PedVacc 002, we assessed hematologic profiles of infants born to mothers receiving ART. All mother...

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Published inRetrovirology : Research and Treatment Vol. 2014; no. 6; pp. 1 - 5
Main Authors Njuguna, Irene, Reilly, Marie, Jaoko, Walter, Gichuhi, Christine, Ambler, Gwen, Maleche-Obimbo, Elizabeth, Lohman-Payne, Barbara, Hanke, Tomás, John-Stewart, Grace
Format Journal Article
LanguageEnglish
Published United States SAGE Publishing 2014
Sage Publications Ltd. (UK)
Sage Publications Ltd
Subjects
Antiviral agents
Breast feeding
Care and treatment
Complications and side effects
Disease transmission
Diseases
Health aspects
HIV (Viruses)
Infants (Newborn)
Medicin och hälsovetenskap
Methods
Neutropenia
Patient outcomes
Prevention
Risk factors
Africa
antiretroviral
neutropenia
PMTCT
breastfeeding
HIV
infant
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Summary:Maternal antiretroviral treatment (ART) is recommended for prevention of mother-to-child HIV-1 transmission (PMTCT), including in women with high CD4 cell counts. Within a pediatric HIV-1 vaccine trial PedVacc 002, we assessed hematologic profiles of infants born to mothers receiving ART. All mothers had CD4 cell counts of >350 mm ; 93% received zidovudine-containing ART; infants received nevirapine up to 6 weeks and cotrimoxazole after 6 weeks. Among 84 infants at 19 weeks, 58% had hematologic toxicity; 44% had neutropenia and 23% had anemia. Breastfeeding was associated with 3.8-fold higher risk of neutropenia (RR 3.8, 95% CI 1.03-14.1, p = 0.008). Hematologic monitoring and PMTCT regimen selection are important for optimizing infant outcomes.
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Conceived and designed the experiments: IN, MR, TH, GJ-S. Analyzed the data: MR and IN. Wrote the first draft of the manuscript: IN. Contributed to the writing of the manuscript: IN, MR, TH, GJ-S. Agree with manuscript results and conclusions: IN, MR, WJ, CG, GA, EM-O, BL-P, TH, and GJ-S. Jointly developed the structure and arguments for the paper: IN, MR, TH, G J-S. Made critical revisions and approved final version: IN, MR, WJ, CG, GA, EM-O, BL-P, TH, and GJ-S. All authors reviewed and approved of the final manuscript.
Author Contributions
ISSN:1178-1238
1178-1238
DOI:10.4137/RRT.S13267