Trial reportThe New England journal of medicine2008
Effects of early, abrupt weaning on HIV-free survival of children in Zambia.
Trial report in The New England journal of medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT00310726 (Short Duration Exclusive Breastfeeding With Abrupt Weaning to Reduce the Risk of Mother-to-Child HIV Transmission), which is not on this map. Cited by 151 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Short Duration Exclusive Breastfeeding With Abrupt Weaning to Reduce the Risk of Mother-to-Child HIV Transmission
Who cites it
151 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Under-five mortality according to maternal survival: a systematic review and meta-analysis.Bulletin of the World Health Organization · 2017Pooled it
- The magnitude of loss to follow-up of HIV-exposed infants along the prevention of mother-to-child HIV transmission continuum of care: a systematic review and meta-analysis.AIDS (London, England) · 2013Pooled it
- Pooled it
- HIV: prevention of mother-to-child transmission.BMJ clinical evidence · 2011Pooled it
- Interventions for preventing late postnatal mother-to-child transmission of HIV.The Cochrane database of systematic reviews · 2009Pooled it
- A.S.P.E.N. clinical guidelines: nutrition support of children with human immunodeficiency virus infection.JPEN. Journal of parenteral and enteral nutritionGuideline
- Predictors of Cell-Associated Human Immunodeficiency Virus (HIV)-1 DNA Over 1 Year in Very Early Treated Infants.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Trial
- Trial
- The aetiology of diarrhoea, pneumonia and respiratory colonization of HIV-exposed infants randomized to breast- or formula-feeding.Paediatrics and international child health · 2016Trial
- Exclusive Breast-feeding Protects against Mother-to-Child Transmission of HIV-1 through 12 Months of Age in Tanzania.Journal of tropical pediatrics · 2016Trial
- HIV transmission and 24-month survival in a randomized trial of HAART to prevent MTCT during pregnancy and breastfeeding in Botswana.AIDS (London, England) · 2013Trial
- Trial
- Human milk oligosaccharide concentration and risk of postnatal transmission of HIV through breastfeeding.The American journal of clinical nutrition · 2012Trial
- Infant feeding practices were not associated with breast milk HIV-1 RNA levels in a randomized clinical trial in Botswana.AIDS and behavior · 2012Trial
- Maternal and infant antiretroviral regimens to prevent postnatal HIV-1 transmission: 48-week follow-up of the BAN randomised controlled trial.Lancet (London, England) · 2012Trial
- Efficacy and safety of an extended nevirapine regimen in infant children of breastfeeding mothers with HIV-1 infection for prevention of postnatal HIV-1 transmission (HPTN 046): a randomised, double-blind, placebo-controlled trial.Lancet (London, England) · 2012Trial
- Exclusive breastfeeding, maternal HIV disease, and the risk of clinical breast pathology in HIV-infected, breastfeeding women.American journal of obstetrics and gynecology · 2011Trial
- Early weaning increases diarrhea morbidity and mortality among uninfected children born to HIV-infected mothers in Zambia.The Journal of infectious diseases · 2011Trial
- Triple-antiretroviral prophylaxis to prevent mother-to-child HIV transmission through breastfeeding--the Kisumu Breastfeeding Study, Kenya: a clinical trial.PLoS medicine · 2011Trial
- Lactation-associated postpartum weight changes among HIV-infected women in Zambia.International journal of epidemiology · 2010Trial
91 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
- Erratum issued
Authors and funding
14 authors.
Funding
Abstract
backgroundIn low-resource settings, many programs recommend that women who are infected with the human immunodeficiency virus (HIV) stop breast-feeding early. We conducted a randomized trial to evaluate whether abrupt weaning at 4 months as compared with the standard practice has a net benefit for HIV-free survival of children.
methodsWe enrolled 958 HIV-infected women and their infants in Lusaka, Zambia. All the women planned to breast-feed exclusively to 4 months; 481 were randomly assigned to a counseling program that encouraged abrupt weaning at 4 months, and 477 to a program that encouraged continued breast-feeding for as long as the women chose. The primary outcome was either HIV infection or death of the child by 24 months.
resultsIn the intervention group, 69.0% of the mothers stopped breast-feeding at 5 months or earlier; 68.8% of these women reported the completion of weaning in less than 2 days. In the control group, the median duration of breast-feeding was 16 months. In the overall cohort, there was no significant difference between the groups in the rate of HIV-free survival among the children; 68.4% and 64.0% survived to 24 months without HIV infection in the intervention and control groups, respectively (P=0.13). Among infants who were still being breast-fed and were not infected with HIV at 4 months, there was no significant difference between the groups in HIV-free survival at 24 months (83.9% and 80.7% in the intervention and control groups, respectively; P=0.27). Children who were infected with HIV by 4 months had a higher mortality by 24 months if they had been assigned to the intervention group than if they had been assigned to the control group (73.6% vs. 54.8%, P=0.007).
conclusionsEarly, abrupt cessation of breast-feeding by HIV-infected women in a low-resource setting, such as Lusaka, Zambia, does not improve the rate of HIV-free survival among children born to HIV-infected mothers and is harmful to HIV-infected infants.(ClinicalTrials.gov number, NCT00310726.)
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.