Duration, Pattern of Breastfeeding and Postnatal Transmission of HIV Pooled Analysis of Individual Data from West and South African Cohorts 英文参考文献.docVIP

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Duration, Pattern of Breastfeeding and Postnatal Transmission of HIV Pooled Analysis of Individual Data from West and South African Cohorts 英文参考文献.doc

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Duration, Pattern of Breastfeeding and Postnatal Transmission of HIV Pooled Analysis of Individual Data from West and South African Cohorts 英文参考文献

Duration,PatternofBreastfeedingandPostnatal TransmissionofHIV:PooledAnalysisofIndividualData fromWestandSouthAfricanCohorts RenaudBecquet1,2,3*,RuthBland1,4,Vale′rianeLeroy2,3,NigelC.Rollins1,5,DidierK.Ekouevi2,3,6 ,Anna Coutsoudis5,Franc?ois Dabis2,3,HoosenM.Coovadia7,RogerSalamon2,3,Marie-LouiseNewell1,8 1Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Somkhele, South Africa, 2INSERM, unite′ 897, Centre de recherche ‘‘Epide′miologie et Biostatistique’’,Bordeaux,France,3InstitutdeSante′ PubliqueEpide′miologieDe′veloppement(ISPED),Universite′ VictorSegalenBordeaux2,Bordeaux,France,4Division ofDevelopmentalMedicine,UniversityofGlasgow,Glasgow,UnitedKingdom,5DepartmentofPaediatricsandChildHealth,UniversityofKwaZulu-Natal,Durban,South Africa,6ANRSsiteinCo?ted’Ivoire(PAC-CI),CentreHospitalierUniversitairedeTreichville,Abidjan,Co?ted’Ivoire,7CentreforHIV/AIDSNetworking,UniversityofKwaZulu- Natal,Durban,SouthAfrica,8CentreforPaediatricEpidemiologyandBiostatistics,InstituteofChildHealth,UniversityCollegeLondon,London,UnitedKingdom Abstract Background: Both breastfeeding pattern and duration are associated with postnatal HIV acquisition; their relative contributionhasnotbeenreliablyquantified. MethodologyandPrincipalFindings:Pooleddatafrom2cohorts:inurbanWestAfricawherebreastfeedingcessationat4 monthswasrecommendedbutexclusivebreastfeedingwasrare(DitramePlus,DP);inruralSouthAfricawherehighratesof exclusive breastfeeding were achieved, but with longer duration (Vertical Transmission Study, VTS). 18-months HIV postnataltransmission(PT)wasestimatedbyKaplan-MeierininfantswhowereHIVnegative,andassumeduninfected,at age.1month.Censoringwith(toassessimpactofmodeofbreastfeeding)andwithout(toassesseffectofbreastfeeding duration)breastfeedingcessationconsideredasacompetingevent.Of1195breastfedinfants,notHIV-infectedperinatally, 38%DPand83%VTSchildrenwerestillbreastfedatage6months.Byage3months,66%ofVTSchildrenwereexclusively breastfed since birth and