Trial reportPloS one2009
Differential effects of early weaning for HIV-free survival of children born to HIV-infected mothers by severity of maternal disease.
Trial report in PloS one, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 25 papers.
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
ART Readiness in HIV-infected Pregnant Women: From Formative Qualitative Research to Individual Randomized Trial
Who cites it
25 citing papers in PubMed.
- Lipid-based nutrient supplements are feasible as a breastmilk replacement for HIV-exposed infants from 24 to 48 weeks of age.The Journal of nutrition · 2013Trial
- 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
- Effect of nutritional supplementation of breastfeeding HIV positive mothers on maternal and child health: findings from a randomized controlled clinical trial.BMC public health · 2011Trial
- Early weaning increases diarrhea morbidity and mortality among uninfected children born to HIV-infected mothers in Zambia.The Journal of infectious diseases · 2011Trial
- Review
- Longitudinal gut microbiota composition of South African and Nigerian infants in relation to tetanus vaccine responses.Microbiology spectrum · 2024Article
- Longitudinal gut microbiota composition of South African and Nigerian infants in relation to tetanus vaccine responses.Research square · 2023Article
- Article
- HIV and SIV in Body Fluids: From Breast Milk to the Genitourinary Tract.Current immunology reviews · 2019Article
- Genome-wide scan in two groups of HIV-infected patients treated with dendritic cell-based immunotherapy.Immunologic research · 2016Article
- Protective Role of BST2 Polymorphisms in Mother-to-Child Transmission of HIV-1 and Adult AIDS Progression.Journal of acquired immune deficiency syndromes (1999) · 2016Article
- Increased Cytomegalovirus Secretion and Risks of Infant Infection by Breastfeeding Duration From Maternal Human Immunodeficiency Virus Positive Compared to Negative Mothers in Sub-Saharan Africa.Journal of the Pediatric Infectious Diseases Society · 2016Article
- Growth of HIV-Exposed Uninfected Infants in the First 6 Months of Life in South Africa: The IeDEA-SA Collaboration.PloS one · 2016Article
- Adherence to WHO breastfeeding guidelines among HIV positive mothers in Southern Ethiopia: implication for intervention.Pediatric health, medicine and therapeutics · 2015Article
- Does the national program of prevention of mother to child transmission of HIV (PMTCT) reach its target in Ouagadougou, Burkina Faso?African health sciences · 2014Article
- Immunology of pediatric HIV infection.Immunological reviews · 2013Review
- Human cytomegalovirus infant infection adversely affects growth and development in maternally HIV-exposed and unexposed infants in Zambia.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2012Article
- HIV-free survival among nine- to 24-month-old children born to HIV-positive mothers in the Rwandan national PMTCT programme: a community-based household survey.Journal of the International AIDS Society · 2012Article
- Predictors of CD4 eligibility for antiretroviral therapy initiation among HIV-infected pregnant women in Lusaka, Zambia.Journal of acquired immune deficiency syndromes (1999) · 2011Article
- Current knowledge and future research on infant feeding in the context of HIV: basic, clinical, behavioral, and programmatic perspectives.Advances in nutrition (Bethesda, Md.) · 2011Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
backgroundWe previously reported no benefit of early weaning for HIV-free survival of children born to HIV-infected mothers in intent-to-treat analyses. Since early weaning was poorly accepted, we conducted a secondary analysis to investigate whether beneficial effects may have been hidden.
methods958 HIV-infected women in Lusaka, Zambia, were randomized to abrupt weaning at 4 months (intervention) or to continued breastfeeding (control). Children were followed to 24 months with regular HIV PCR tests and examinations to determine HIV infection or death. Detailed behavioral data were collected on when all breastfeeding ended. Most participants were recruited before antiretroviral treatment (ART) became available. We compared outcomes among mother-child pairs who weaned earlier or later than intended by study design adjusting for potential confounders.
resultsOf infants alive, uninfected and still breastfeeding at 4 months in the intervention group, 16.1% who weaned as instructed acquired HIV or died by 24 months compared to 16.0% who did not comply (p = 0.98). Children of women with less severe disease during pregnancy (not eligible for ART) had worse outcomes if their mothers weaned as instructed (RH = 2.60 95% CI: 1.06-6.36) compared to those who continued breastfeeding. Conversely, children of mothers with more severe disease (eligible for ART but did not receive it) who weaned early had better outcomes (p-value interaction = 0.002). In the control group, weaning before 15 months was associated with 3.94-fold (95% CI: 1.65-9.39) increase in HIV infection or death among infants of mothers with less severe disease.
conclusionIncomplete adherence did not mask a benefit of early weaning. On the contrary, for women with less severe disease, early weaning was harmful and continued breastfeeding resulted in better outcomes. For women with more advanced disease, ART should be given during pregnancy for maternal health and to reduce transmission, including through breastfeeding.
trial registration(ClinicalTrials.gov) NCT00310726.
Indexed as
Identifiers
What OpenQuestion holds
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.