BACKGROUND: The effect of abrupt weaning, advocated as a safe transition from exclusive breastfeeding in HIV-exposed children, on the quantity of HIV viral load in breast milk (BMVL) is not known. OBJECTIVES: To determine the effect of abrupt cessation of breastfeeding on serum prolactin, pumped breast milk volume and BMVL obtained 2 weeks after rapid weaning in HIV-infected women. METHODS:Women enrolled in a prospective study (ZEBS) were randomized to abruptly wean at 20 weeks postpartum or continue exclusive breastfeeding. Breast milk was obtained at 22 weeks by electric breast pump over 10 min from 222 women who had either weaned or continued to breastfeed. Pre- and post-pumping prolactin was measured. BMVL was measured at 20 and 22 weeks in 71 randomly selected women from both groups. RESULTS:Baseline prolactin and breast milk volume was significantly lower among women who had weaned. Detectable (68 versus 42%; P = 0.03) and median BMVL (448 versus < 50 copies/ml; P = 0.005) was significantly higher among those who had weaned in comparison with those who were still breastfeeding and was significantly higher in the same women after weaning compared with 2 weeks earlier (P = 0.001). CONCLUSIONS:BMVL is substantially higher after rapid weaning and this may pose an increased risk of HIV transmission if children resume breastfeeding after a period of cessation. Increases in BMVL with differing degrees of mixed feeding needs to be assessed.
RCT Entities:
BACKGROUND: The effect of abrupt weaning, advocated as a safe transition from exclusive breastfeeding in HIV-exposed children, on the quantity of HIV viral load in breast milk (BMVL) is not known. OBJECTIVES: To determine the effect of abrupt cessation of breastfeeding on serum prolactin, pumped breast milk volume and BMVL obtained 2 weeks after rapid weaning in HIV-infectedwomen. METHODS:Women enrolled in a prospective study (ZEBS) were randomized to abruptly wean at 20 weeks postpartum or continue exclusive breastfeeding. Breast milk was obtained at 22 weeks by electric breast pump over 10 min from 222 women who had either weaned or continued to breastfeed. Pre- and post-pumping prolactin was measured. BMVL was measured at 20 and 22 weeks in 71 randomly selected women from both groups. RESULTS: Baseline prolactin and breast milk volume was significantly lower among women who had weaned. Detectable (68 versus 42%; P = 0.03) and median BMVL (448 versus < 50 copies/ml; P = 0.005) was significantly higher among those who had weaned in comparison with those who were still breastfeeding and was significantly higher in the same women after weaning compared with 2 weeks earlier (P = 0.001). CONCLUSIONS: BMVL is substantially higher after rapid weaning and this may pose an increased risk of HIV transmission if children resume breastfeeding after a period of cessation. Increases in BMVL with differing degrees of mixed feeding needs to be assessed.
Authors: J E Embree; S Njenga; P Datta; N J Nagelkerke; J O Ndinya-Achola; Z Mohammed; S Ramdahin; J J Bwayo; F A Plummer Journal: AIDS Date: 2000-11-10 Impact factor: 4.177
Authors: J F Willumsen; M L Newell; S M Filteau; A Coutsoudis; S Dwarika; D York; A M Tomkins; H M Coovadia Journal: AIDS Date: 2001-09-28 Impact factor: 4.177
Authors: G C John; R W Nduati; D A Mbori-Ngacha; B A Richardson; D Panteleeff; A Mwatha; J Overbaugh; J Bwayo; J O Ndinya-Achola; J K Kreiss Journal: J Infect Dis Date: 2000-12-15 Impact factor: 5.226
Authors: Michael H Chung; James N Kiarie; Barbra A Richardson; Dara A Lehman; Julie Overbaugh; Grace C John-Stewart Journal: AIDS Date: 2005-09-02 Impact factor: 4.177
Authors: Tin Tin Sint; Ronnie Lovich; Wendy Hammond; Maria Kim; Sara Melillo; Lydia Lu; Pamela Ching; Jennifer Marcy; Nigel Rollins; Emilia H Koumans; Amie N Heap; Margaret Brewinski-Isaacs Journal: AIDS Date: 2013-11 Impact factor: 4.177
Authors: Louise Kuhn; Hae-Young Kim; Jan Walter; Donald M Thea; Moses Sinkala; Mwiya Mwiya; Chipepo Kankasa; Don Decker; Grace M Aldrovandi Journal: Sci Transl Med Date: 2013-04-17 Impact factor: 17.956
Authors: Louise Kuhn; Grace M Aldrovandi; Moses Sinkala; Chipepo Kankasa; Katherine Semrau; Mwiya Mwiya; Prisca Kasonde; Nancy Scott; Cheswa Vwalika; Jan Walter; Marc Bulterys; Wei-Yann Tsai; Donald M Thea Journal: N Engl J Med Date: 2008-06-04 Impact factor: 91.245
Authors: Kiersten A Israel-Ballard; Barbara F Abrams; Anna Coutsoudis; Lindiwe N Sibeko; Lynn A Cheryk; Caroline J Chantry Journal: J Acquir Immune Defic Syndr Date: 2008-08-01 Impact factor: 3.731
Authors: Lars T Fadnes; Ingunn M S Engebretsen; Henry Wamani; Jonathan Wangisi; James K Tumwine; Thorkild Tylleskär Journal: BMC Pediatr Date: 2009-01-09 Impact factor: 2.125