Evidence map›Paper›PMID 21468300›Full record

Trial reportPLoS medicine2011

Triple-antiretroviral prophylaxis to prevent mother-to-child HIV transmission through breastfeeding--the Kisumu Breastfeeding Study, Kenya: a clinical trial.

Timothy K Thomas, Rose Masaba, Craig B Borkowf, Richard Ndivo, Clement Zeh, Ambrose Misore, Juliana Otieno, Denise Jamieson, Michael C Thigpen, Marc Bulterys and 6 more

Open access · goldAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PLoS medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 102 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
102citing papers in PubMed, 5 pooled it
12.9field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

102 citing papers in PubMed, 5 syntheses or guidelines pooled it, 176 citations in OpenAlex.

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  3. Antiretroviral interventions for preventing breast milk transmission of HIV.The Cochrane database of systematic reviews · 2014
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42 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 6 institutions in 3 countries.

Timothy K ThomasDivision of HIV/AIDS Prevention, US Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA. tft5@cdc.gov
Rose Masaba
Craig B Borkowf
Richard Ndivo
Clement Zeh
Ambrose Misore
Juliana Otieno
Denise Jamieson
Michael C Thigpen
Marc Bulterys
Laurence Slutsker
Kevin M De Cock
Pauli N Amornkul
Alan E Greenberg
Mary Glenn Fowler
KiBS Study Team
Centers for Disease Control and Prevention · USKenya Medical Research Institute · KECDC Foundation · USCenter for Global Health · USCenters for Disease Control and Prevention · UGMinistry of Health · KE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEffective strategies are needed for the prevention of mother-to-child HIV transmission (PMTCT) in resource-limited settings. The Kisumu Breastfeeding Study was a single-arm open label trial conducted between July 2003 and February 2009. The overall aim was to investigate whether a maternal triple-antiretroviral regimen that was designed to maximally suppress viral load in late pregnancy and the first 6 mo of lactation was a safe, well-tolerated, and effective PMTCT intervention. METHODS AND

findingsHIV-infected pregnant women took zidovudine, lamivudine, and either nevirapine or nelfinavir from 34-36 weeks' gestation to 6 mo post partum. Infants received single-dose nevirapine at birth. Women were advised to breastfeed exclusively and wean rapidly just before 6 mo. Using Kaplan-Meier methods we estimated HIV-transmission and death rates from delivery to 24 mo. We compared HIV-transmission rates among subgroups defined by maternal risk factors, including baseline CD4 cell count and viral load. Among 487 live-born, singleton, or first-born infants, cumulative HIV-transmission rates at birth, 6 weeks, and 6, 12, and 24 mo were 2.5%, 4.2%, 5.0%, 5.7%, and 7.0%, respectively. The 24-mo HIV-transmission rates stratified by baseline maternal CD4 cell count <500 and ≥500 cells/mm(3) were 8.4% (95% confidence interval [CI] 5.8%-12.0%) and 4.1% (1.8%-8.8%), respectively (p = 0.06); the corresponding rates stratified by baseline maternal viral load <10,000 and ≥10,000 copies/ml were 3.0% (1.1%-7.8%) and 8.7% (6.1%-12.3%), respectively (p = 0.01). None of the 12 maternal and 51 infant deaths (including two second-born infants) were attributed to antiretrovirals. The cumulative HIV-transmission or death rate at 24 mo was 15.7% (95% CI 12.7%-19.4%).

conclusionsThis trial shows that a maternal triple-antiretroviral regimen from late pregnancy through 6 months of breastfeeding for PMTCT is safe and feasible in a resource-limited setting. These findings are consistent with those from other trials using maternal triple-antiretroviral regimens during breastfeeding in comparable settings.

Indexed as

Breast FeedingAdolescentAdultAnti-HIV AgentsDelivery, ObstetricDemographyFemaleHIV-1HIV InfectionsHumansInfant, NewbornInfectious Disease Transmission, VerticalKaplan-Meier EstimateKenyaMedication AdherenceMothersAnti-HIV Agents

Identifiers

PMID21468300
PMCPMC3066129
OpenAlexW2165826479

What OpenQuestion holds

Textmetadata
LicenceCC0
Read underepoch 390

Registered trials

None linked

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.