Evidence map›Paper›PMID 28486519›Full record

Trial reportPloS one2017

Changes in body mass index and hemoglobin concentration in breastfeeding women living with HIV with a CD4 count over 350: Results from 4 African countries (The ANRS 12174 trial).

Eric Nagaonlé Somé, Ingunn M S Engebretsen, Nicolas Nagot, Nicolas Y Meda, Roselyne Vallo, Chipepo Kankasa, James K Tumwine, Mandisa Singata, Justus G Hofmeyr, Philippe Van de Perre and 2 more

Open access · goldAbstract readClinical Trial
In one paragraph

Trial report in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 37% 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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
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

12 authors at 7 institutions in 6 countries.

Eric Nagaonlé SoméCentre for International Health, University of Bergen, Bergen, Norway.ORCID http://orcid.org/0000-0002-5356-2598
Ingunn M S EngebretsenCentre for International Health, University of Bergen, Bergen, Norway.
Nicolas NagotINSERM UMR 1058, Pathogenesis and control of chronic infections, Montpellier, France.
Nicolas Y MedaUniversity of Ouagadougou, Faculty of Health Sciences, Centre de Recherche International en Santé (CRIS) Ouagadougou, Burkina Faso.
Roselyne ValloINSERM UMR 1058, Pathogenesis and control of chronic infections, Montpellier, France.
Chipepo KankasaUniversity of Zambia, School of Medicine, Department of Paediatrics and Child Health, University Teaching Hospital, Lusaka, Zambia.
James K TumwineMakerere University, Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Kampala, Uganda.
Mandisa SingataUniversity of Fort Hare, Effective Care Research Unit, Eastern Cape, South Africa.
Justus G HofmeyrUniversity of Fort Hare, Effective Care Research Unit, Eastern Cape, South Africa.
Philippe Van de PerreINSERM UMR 1058, Pathogenesis and control of chronic infections, Montpellier, France.
Thorkild TylleskärCentre for International Health, University of Bergen, Bergen, Norway.
ANRs 12174 Trial Group
Inserm · FRUniversity of Bergen · NOUniversity of Fort Hare · ZACentre National de la Recherche Scientifique et Technologique · BFMakerere University · UGUniversité Joseph Ki-Zerbo · BFUniversity Teaching Hospital · ZM

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionBreastfeeding is recommended for infants born to HIV-infected women in low-income settings. Both breastfeeding and HIV-infection are energy demanding. Our objective was to explore how exclusive and predominant breastfeeding changes body mass index (BMI) among breastfeeding HIV1-positive women participating in the ANRS12174 trial (clinical trial no NCT0064026).

methodsHIV-positive women (n = 1 267) with CD4 count >350, intending to breastfeed HIV-negative infants were enrolled from Burkina Faso, South Africa, Uganda and Zambia and counselled on breastfeeding. N = 1 216 were included in the analysis. The trial compared Lamivudine and Lopinavir/Ritonavir as a peri-exposure prophylaxis. We ran a linear mixed-effect model with BMI as the dependent variable and exclusive or predominant breastfeeding duration as the key explanatory variable.

resultsAny breastfeeding or exclusive/predominant) breastfeeding was initiated by 99.6% and 98.6% of the mothers respectively in the first week after birth. The median (interquartile range: IQR) duration of the group that did any breastfeeding or the group that did exclusive /predominant breastfeeding were 9.5 (7.5; 10.6) and 5.8 (5.6; 5.9)) months, respectively. The median (IQR) age, BMI, CD4 count, and HIV viral load at baseline (day 7) were 27 (23.3; 31) years, 23.7 (21.3; 27.0) kg/m2, 530 (432.5; 668.5) cells/μl and 0.1 (0.8; 13.7)1000 copies/mL, respectively. No major change in mean BMI was seen in this cohort over a 50-week period during lactation. The mean change between 26 and 50 weeks after birth was 0.7 kg/m2. Baseline mean BMI (measured on day 7 postpartum) and CD4 count were positively associated with maternal BMI change, with a mean increase of 1.0 kg/m2 (0.9; 1.0) per each additional baseline-BMI kilogram and 0.3 kg/m2 (0.2; 0.5) for each additional CD4 cell/μl, respectively.

conclusionBreastfeeding was not negatively correlated with the BMI of HIV-1 infected Sub-Saharan African mothers. However, a higher baseline BMI and a CD4 count >500 cells/μl were associated with maternal BMI during the exclusive/ predominant breastfeeding period. Considering the benefits of breast milk for the infants and the recurrent results from different studies that breastfeeding is not harmful to the HIV-1-infected mothers, this study also supports the WHO 2016 guidelines on infant feeding that mothers living with HIV should breastfeed where formula is not safe for at least 12 months and up to 24 months, given that the right treatment or prophylaxis for the infection is administered. These findings and conclusions cannot be extrapolated to women who are immune-compromised or have AIDS.

Indexed as

Body Mass IndexBreast FeedingCD4 Lymphocyte CountAdultAnti-HIV AgentsBurkina FasoFemaleHemoglobinsHIV InfectionsHumansSouth AfricaUgandaYoung AdultZambiaAnti-HIV AgentsHemoglobins

Identifiers

PMID28486519
PMCPMC5423645
OpenAlexW2613104743

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.