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Vertical cytomegalovirus transmission from HIV-infected women randomized to formula feeding versus breastfeeding

Emery, VC, Richardson, BA, John-Stewart, G, Atkinson, C, Nduati, R, Asbjornsdottir, K, Boeckh, M, Overbaugh, J and Slyker, JA (2016) Vertical cytomegalovirus transmission from HIV-infected women randomized to formula feeding versus breastfeeding Journal of Infectious Diseases.

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Abstract

Background. Cytomegalovirus (CMV) is associated with morbidity and mortality in human immunodeficiency virus (HIV)–exposed infants. We assessed the effect of and relative contribution of breastfeeding to CMV acquisition among infants delivered by HIV-infected mothers. Methods. Between 1993 and 1998 pregnant, HIV-infected women in Nairobi, Kenya, were randomly assigned to breastfeed or formula-feed their infants in an HIV transmission study. Women were allocated equally between treatment arms, and the study was not blinded. The primary endpoint of this nested study was time to infant CMV infection. Results. CMV infection was assessed in 138 breastfed and 134 formula-fed infants. Baseline characteristics were similar between arms. Breastfed infants acquired CMV earlier than formula-fed infants (median age of acquisition, 4.26 vs 9.87 months; P < .001) and had a higher 1-year probability of CMV infection (0.89 vs 0.69; P < .001). Breastfeeding was associated with a 1.6-fold increased risk of infant CMV acquisition independent of infant HIV status (multivariable hazard ratio, 1.61; 95% confidence interval, 1.20–2.16; P = .002). Approximately one third of CMV infections occurred during the peripartum period, with 40% acquired through breastfeeding and the remainder acquired through modes other than breast milk.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine > Department of Microbial and Cellular Sciences
Authors :
AuthorsEmailORCID
Emery, VCUNSPECIFIEDUNSPECIFIED
Richardson, BAUNSPECIFIEDUNSPECIFIED
John-Stewart, GUNSPECIFIEDUNSPECIFIED
Atkinson, CUNSPECIFIEDUNSPECIFIED
Nduati, RUNSPECIFIEDUNSPECIFIED
Asbjornsdottir, KUNSPECIFIEDUNSPECIFIED
Boeckh, MUNSPECIFIEDUNSPECIFIED
Overbaugh, JUNSPECIFIEDUNSPECIFIED
Slyker, JAUNSPECIFIEDUNSPECIFIED
Date : 1 January 2016
Identification Number : 10.1093/infdis/jiv515
Related URLs :
Additional Information : This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Journal of Infectious Diseases following peer review. The definitive publisher-authenticated version Emery, VC, Richardson, BA, John-Stewart, G, Atkinson, C, Nduati, R, Asbjornsdottir, K, Boeckh, M, Overbaugh, J and Slyker, JA (2016) Vertical cytomegalovirus transmission from HIV-infected women randomized to formula feeding versus breastfeeding Journal of Infectious Diseases will be available online at: http://jid.oxfordjournals.org/
Depositing User : Symplectic Elements
Date Deposited : 30 Oct 2015 11:29
Last Modified : 30 Oct 2016 02:08
URI: http://epubs.surrey.ac.uk/id/eprint/809129

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