Trial reportAIDS (London, England)2008
HIV-1 persists in breast milk cells despite antiretroviral treatment to prevent mother-to-child transmission.
Trial report in AIDS (London, England), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00167674 (ARVs to Prevent Breastmilk HIV), which is not on this map. Cited by 33 papers, 2 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.
ARVs to Prevent Breastmilk HIV:Viral and Immune Responses
Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection.The Cochrane database of systematic reviews · 2011Pooled it
- Antiretroviral therapy (ART) for treating HIV infection in ART-eligible pregnant women.The Cochrane database of systematic reviews · 2010Pooled it
- Dynamic Changes in Breast Milk Microbiome in the Early Postpartum Period of Kenyan Women Living with HIV Are Influenced by Antibiotics but Not Antiretrovirals.Microbiology spectrum · 2022Trial
- Maternal Highly Active Antiretroviral Therapy Reduces Vertical Cytomegalovirus Transmission But Does Not Reduce Breast Milk Cytomegalovirus Levels.AIDS research and human retroviruses · 2017Trial
- Lower risk of resistance after short-course HAART compared with zidovudine/single-dose nevirapine used for prevention of HIV-1 mother-to-child transmission.Journal of acquired immune deficiency syndromes (1999) · 2009Trial
- Highly active antiretroviral therapy versus zidovudine/nevirapine effects on early breast milk HIV type-1 Rna: a phase II randomized clinical trial.Antiviral therapy · 2008Trial
- Associations of Plasma and Breast Milk HIV RNA and Tenofovir Concentrations With Risk of Postnatal HIV Transmission During Breastfeeding Among Women With and Without ARV Exposure.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Article
- Review
- Maternal and health care workers' perspectives on exclusive breastfeeding in the context of maternal HIV infection, in Busia county, western Kenya: a mixed methods cross-sectional survey.International breastfeeding journal · 2022Article
- Human Immunodeficiency Virus (HIV) and Human Cytomegalovirus (HCMV) Coinfection of Infant Tonsil Epithelium May Synergistically Promote both HIV-1 and HCMV Spread and Infection.Journal of virology · 2021Article
- Observational
- HIV and SIV in Body Fluids: From Breast Milk to the Genitourinary Tract.Current immunology reviews · 2019Article
- Systemic administration of an HIV-1 broadly neutralizing dimeric IgA yields mucosal secretory IgA and virus neutralization.Mucosal immunology · 2017Article
- Are T cells the only HIV-1 reservoir?Retrovirology · 2016Review
- Maternal plasma and breastmilk viral loads are associated with HIV-1-specific cellular immune responses among HIV-1-exposed, uninfected infants in Kenya.Clinical and experimental immunology · 2015Article
- The role of cell-associated virus in mother-to-child HIV transmission.The Journal of infectious diseases · 2014Review
- The oral mucosa immune environment and oral transmission of HIV/SIV.Immunological reviews · 2013Review
- Cell-free (RNA) and cell-associated (DNA) HIV-1 and postnatal transmission through breastfeeding.PloS one · 2012Article
- Incidence and correlates of HIV-1 RNA detection in the breast milk of women receiving HAART for the prevention of HIV-1 transmission.PloS one · 2012Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundThe effects of short-course antiretrovirals given to reduce mother-to-child transmission (MTCT) on temporal patterns of cell-associated HIV-1 RNA and DNA in breast milk are not well defined.
methodsWomen in Kenya received short-course zidovudine (ZDV), single-dose nevirapine (sdNVP), combination ZDV/sdNVP or short-course highly active antiretroviral therapy (HAART). Breast milk samples were collected two to three times weekly for 4-6 weeks. HIV-1 DNA was quantified by real-time PCR. Cell-free and cell-associated RNA levels were quantified by the Gen-Probe HIV-1 viral load assay.
resultsCell-free HIV-1 RNA levels in breast milk were significantly suppressed by sdNVP, ZDV/sdNVP or HAART therapy compared with ZDV between day 3 and week 4 postpartum (P < or = 0.03). Breast milk HIV-1 DNA levels (infected cell levels) were not significantly different between treatment arms at any timepoint during the 4-6-week follow-up. At 3 weeks postpartum, when the difference in cell-free RNA levels was the greatest comparing HAART directly with ZDV (P = 0.0001), median log10 HIV-1 DNA copies per 1 x 10 cells were 2.78, 2.54, 2.69, and 2.31 in the ZDV, sdNVP, ZDV/sdNVP and HAART arms, respectively (P = 0.23). Cell-associated HIV-1 RNA levels were modestly suppressed in HAART versus ZDV/sdNVP during week 3 (3.37 versus 4.02, P = 0.04), as well as over time according to a linear mixed-effects model.
conclusionCell-free and, to a lesser extent, cell-associated HIV-1 RNA levels in breast milk were suppressed by antiretroviral regimens used to prevent MTCT. However, even with HAART, there was no significant reduction in the reservoir of infected cells, which could contribute to breast milk HIV-1 transmission.
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Registered trials
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.