Evidence map›Paper›PMID 26525557›Full record

ArticleMaternal and child health journal2016

Maternal Highly Active Antiretroviral Therapy and Child HIV-Free Survival in Malawi, 2004-2009.

Sheree R Schwartz, Newton Kumwenda, Johnstone Kumwenda, Shu Chen, Lynne M Mofenson, Allan W Taylor, Mary Glenn Fowler, Taha E Taha

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Maternal and child health journal, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00115648 (Extended Infant Post-exposure Prophylaxis With Antiretrovirals to Reduce Postnatal HIV Transmission), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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.

NCT00115648 phase3completednot on this map

Extended Infant Post-exposure Prophylaxis With Antiretrovirals to Reduce Postnatal HIV Transmission

TypeinterventionalSponsorJohns Hopkins Bloomberg School of Public HealthRan2004 to 2009Enrolled3,300ConditionsHIV InfectionsArmsNevirapine, AZT, NVP and AZT, NVP, NVP+AZT
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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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

8 authors.

Sheree R SchwartzDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, E7139, Baltimore, MD, 21205, USA. sschwartz@jhu.edu.
Newton KumwendaDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, E7139, Baltimore, MD, 21205, USA.
Johnstone KumwendaDepartment of Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.
Shu ChenDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, E7139, Baltimore, MD, 21205, USA.
Lynne M MofensonEunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA.
Allan W TaylorEpidemiology Branch, Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Mary Glenn FowlerDepartment of Pathology, Johns Hopkins Medical School, Baltimore, MD, USA.
Taha E TahaDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, E7139, Baltimore, MD, 21205, USA. ttaha1@jhu.edu.

Funding

inter epi.research studies to reduce mother to child HIV-1 transU50PS022061 · PS · UNIVERSITY OF MALAWI · PI KUMWENDA, NEWTON ISAAC · 2005 to 2008
$2.5M
NCHHSTP CDC HHS 5 U50 PS022061-05NCHHSTP CDC HHS U50 PS022061ODCDC CDC HHS U50/CC0222061
6 · The paper itself

Abstract

objectivesHighly active antiretroviral therapy (HAART) provision to eligible HIV-infected pregnant and post-partum women is critical for optimizing maternal health. We assessed the impact of maternal HAART on HIV-free survival of breastfed infants in Malawi.

methodsThe post-exposure prophylaxis of infants-Malawi trial (2004-2009) enrolled mothers/infants during labor or immediately post-partum to evaluate 14-week extended infant antiretroviral prophylaxis for preventing HIV transmission through breastfeeding. Mothers meeting national HAART guidelines were referred for therapy. Child HIV-free survival-survival without HIV infection-was compared by maternal HAART status.

resultsOverall, 3022 mother-infant pairs contributed 4214 infant/person-years (PY) at-risk for HIV infection or death, with 532 events (incidence 12.6/100 PY, 95 % confidence interval [CI] 11.6-13.7). During follow-up, 349 mothers were HAART initiated; 581 remained HAART naïve with CD4 cell counts <250 cells/mm(3), and 2092 were never HAART-eligible. By 3 months, 11 % of infants with HAART naïve mothers (CD4 < 250) were infected with HIV or died versus 7 % of infants of HAART-initiated mothers and 4 % of infants of HAART-ineligible mothers. Maternal HAART was associated with a 46 % reduction in infant HIV infection or death as compared to infants with HAART naïve mothers (CD4 < 250) (adjusted hazards ratio 0.54, 95 % CI 0.36-0.81). Among HIV-exposed, uninfected infants, breastfeeding, but not HAART, was significantly associated with decreased child mortality.

conclusionsHIV infection and mortality are high during the first 3 months post-partum in infants of mothers with advanced HIV, and rapid maternal HAART initiation can significantly improve HIV-related infant outcomes. Clinical Trials Registration This study is registered at http://clinicaltrials.gov/ under trial number NCT00115648.

Indexed as

Antiretroviral Therapy, Highly ActiveBreast FeedingAdultCD4 Lymphocyte CountFemaleFollow-Up StudiesHIV InfectionsHumansInfantInfectious Disease Transmission, VerticalMalawiMothersPostpartum PeriodPregnancyPregnancy Complications, InfectiousPregnancy OutcomeBreastfeedingChild survivalHighly active antiretroviral therapyHIV-1Prevention of mother-to-child transmission

Identifiers

PMID26525557
PMCPMC4754130

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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.