Peripartum HIV infection in very low birth weight infants fed ‘raw’ mother’s own milk
| Autor: | S D Delport, Melantha Coetzee |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Pediatrics
medicine.medical_specialty Nevirapine Raw breast milk Very low birth weight Mother’s own milk 030312 virology Breast milk 03 medical and health sciences 0302 clinical medicine Pharmacotherapy medicine Cumulative incidence 030212 general & internal medicine Original Research Prevention of mother-to-child transmission 0303 health sciences Maternal Transmission Mother-to-child transmission business.industry lcsh:Public aspects of medicine Peripartum transmission HIV virus diseases lcsh:RA1-1270 Low birth weight Infectious Diseases Population study medicine.symptom business Breast feeding medicine.drug |
| Zdroj: | Southern African Journal of HIV Medicine Southern African Journal of HIV Medicine, Vol 20, Iss 1, Pp e1-e7 (2019) |
| ISSN: | 2078-6751 1608-9693 |
| DOI: | 10.4102/sajhivmed.v20i1.912 |
| Popis: | Background: HIV-exposed very low birth weight (VLBW) infants (≤ 1500 g) are considered at high risk of peripartum mother-to-child HIV transmission (MTCT). In the past, they received formula to prevent breast milk related HIV transmission. This denied them the benefits of breast milk, thus exposing the infant to the risk of necrotising enterocolitis (NEC). From 2010, ‘raw’ mother’s own milk (rMOM) has been recommended for term infants whose mothers’ received antenatal antiretroviral therapy (ART). At the same time, the infant received antiretroviral (ARV) prophylaxis as per the National Prevention of MTCT programme. Objectives: To determine the cumulative incidence of peripartum HIV infection by 4–6 weeks of age in HIV-exposed VLBW infants, who received rMOM and infant ARV prophylaxis. Method: A retrospective, observational audit over 3 years at a single institution was undertaken. The study population comprised HIV-exposed VLBW infants who received both nevirapine prophylaxis and rMOM from birth until discharge. A positive HIV-PCR by 4–6 weeks of life was used to confirm maternal to infant HIV transmission. Results: Of the 80 eligible infants admitted between 2010 and 2013, 63 (79%) were exposed to antenatal ART. Seventy-eight (97.5%) tested HIV-PCR negative at 4–6 weeks. Of the two infants who tested positive, both presented with features of an acute HIV infection. The absence of MTCT in the remaining 78 infants given ARV prophylaxis and rMOM suggests that rMOM is an unlikely source of infection in the two infected infants. Conclusion: rMOM, in the presence of infant prophylaxis, was a safe feeding option for HIV-exposed VLBW infants. It should be strongly considered for these infants, as rMOM likely provides additional maternal and child benefits. |
| Databáze: | OpenAIRE |
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