Evidence map›Paper›PMID 34415933›Full record

Trial reportPloS one2021

Effect on growth of exposure to maternal antiretroviral therapy in breastmilk versus extended infant nevirapine prophylaxis among HIV-exposed perinatally uninfected infants in the PROMISE randomized trial.

Lynda Stranix-Chibanda, Camlin Tierney, Mauricio Pinilla, Kathleen George, Jim Aizire, Godwin Chipoka, Macpherson Mallewa, Megeshinee Naidoo, Teacler Nematadzira, Bangani Kusakara and 11 more

Registry-linked trialOpen access · goldAbstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01061151 (Breastfeeding Version of the PROMISE Study), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.4field-weighted citation impact, top 43% 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.

NCT01061151 phase3completednot on this map

Breastfeeding Version of the PROMISE Study (Promoting Maternal and Infant Survival Everywhere)

TypeinterventionalSponsorNational Institute of Allergy and Infectious Diseases (NIAID)Ran2011 to 2016Enrolled3,747ConditionsHIV InfectionsArmsZidovudine (ZDV), Nevirapine (NVP): Antepartum Mothers, Emtricitabine-tenofovir disoproxil fumarate (Truvada [TRV]) tail, Lamivudine-Zidovudine (3TC-ZDV), Lopinavir-ritonavir (LPV-RTV)
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 4 citations in OpenAlex.

  1. Trial
  2. Longitudinal comparison of bone, growth, and biochemical markers in breastfed HIV-exposed uninfected and HIV-unexposed Ugandan children.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2026
    Article
  3. Article
  4. Article
  5. 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

21 authors at 13 institutions in 8 countries.

Lynda Stranix-ChibandaUniversity of Zimbabwe Faculty of Medicine and Health Sciences, Child and Adolescent Health Unit, Harare, Zimbabwe.ORCID 0000-0003-3566-1688
Camlin TierneyHarvard T.H. Chan School of Public Health, Center for Biostatistics in AIDS Research in the Department of Biostatistics, Boston, MA, United States of America.
Mauricio PinillaHarvard T.H. Chan School of Public Health, Center for Biostatistics in AIDS Research in the Department of Biostatistics, Boston, MA, United States of America.
Kathleen GeorgeFHI 360, Durham, NC, United States of America.
Jim AizireMakerere University-Johns Hopkins University Research Programme, Kampala, Uganda.ORCID 0000-0002-4408-8839
Godwin ChipokaUniversity of North Carolina Project, Lilongwe, Malawi.
Macpherson MallewaCollege of Medicine-Johns Hopkins University Project, Blantyre, Malawi.
Megeshinee NaidooUniversity of KwaZulu-Natal, Centre Aids Prevention Research South Africa (CAPRISA), Durban, South Africa.
Teacler NematadziraUniversity of Zimbabwe Clinical Trials Research Centre, Harare, Zimbabwe.
Bangani KusakaraUniversity of Zimbabwe Clinical Trials Research Centre, Harare, Zimbabwe.
Avy ViolariPerinatal HIV Research Unit, Johannesburg, South Africa.
Tapiwa MbengeranwaUniversity of Zimbabwe Clinical Trials Research Centre, Harare, Zimbabwe.
Boniface NjauKilimanjaro Christian Medical Center, Moshi, United Republic of Tanzania.
Lee FairlieWits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa.ORCID 0000-0001-5327-1734
Gerard TheronDepartment of Obstetrics and Gynaecology, Stellenbosch University, Cape Town, South Africa.
Mwangelwa Mubiana-MbeweCentre for Infectious Disease Research in Zambia, Lusaka, Zambia.
Sandhya KhadseDepartment of Obstetrics and Gynaecology, BJ Government Medical College, Pune, India.
Renee BrowningDivision of AIDS, National Institute of Allergy and Infectious Diseases, Bethesda, MD, United States of America.
Mary Glenn FowlerJohns Hopkins University School of Medicine, Baltimore, MD, United States of America.
George K SiberryOffice of HIV/AIDS, United States Agency for International Development, Washington, DC, United States of America.ORCID 0000-0002-5999-1596
PROMISE Study Team
University of Zimbabwe · ZWJohns Hopkins University · USCancer Research And Biostatistics · USAIDS United · USB. J. Medical College & Sassoon Hospital · INCentre for Infectious Disease Research in Zambia · ZMCentre for the AIDS Programme of Research in South Africa · ZAFamily Health International 360 · USKilimanjaro Christian Medical Centre · TZNational Institute of Allergy and Infectious Diseases · USPerinatal HIV Research Unit · ZAStellenbosch University · ZAUniversity of the Witwatersrand · ZA

Funding

LOC-IMPAACT Leadership GroupPharmacokinetics and Safety of Remdesivir for Treatment of COVID-19 in Pregnant Women in the USUM1AI068632 · NIAID · SOCIAL AND SCIENTIFIC SYSTEMS, INC. · PI Jennifer Jao, Sharon A Nachman · 2011 to 2026
$278.1M
Statistical and Data Management Center (SDMC), AIDS Clinical Trials Group (ACTG)UM1AI068634 · NIAID · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Marlene Ann Cooper, Michael David Hughes · 2011 to 2026
$246.6M
Statistical and Data Management Center-Pediatric,Adolescent, and Maternal CTGUM1AI068616 · NIAID · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Sean Scott Brummel, Marlene Ann Cooper · 2011 to 2026
$155.6M
International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) GroupU01AI068632 · NIAID · SOCIAL AND SCIENTIFIC SYSTEMS, INC. · PI JACKSON, J BROOKS · 2006 to 2010
$109.7M
UZ-UCSF CTUUM1AI069436 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI ZVAVAHERA MIKE CHIRENJE, LYNDA STRANIX-CHIBANDA · 2012 to 2026
$75.9M
UZ-UCSF Clinical Trials UnitU01AI069436 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CHIRENJE, ZVAVAHERA MIKE · 2007 to 2011
$49.3M
LC - IMPAACT Leadership GroupUM1AI106716 · NIAID · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Grace M Aldrovandi · 2014 to 2026
$47.2M
The Malawi Clinical Trials UnitUM1AI069518 · NIAID · JOHNS HOPKINS UNIVERSITY · PI JACKY M JENNINGS, TAHA E TAHA · 2012 to 2026
$43.8M
The Johns Hopkins University - Uganda Clinical Trials UnitUM1AI069530 · NIAID · JOHNS HOPKINS UNIVERSITY · PI MARY Glenn Fowler, Philippa Musoke · 2012 to 2026
$34.8M
Wits HIV Research Group CLINICAL TRIAL UNIT (CTU) reapplicationUM1AI069463 · NIAID · WITS HEALTH CONSORTIUM (PTY), LTD · PI REES, HELEN, SANNE, IAN MATTHIAS · 2012 to 2025
$31.8M
NIAID NIH HHS U01 AI068632NIAID NIH HHS U01 AI069436NIAID NIH HHS UM1 AI068616NIAID NIH HHS UM1 AI068632NIAID NIH HHS UM1 AI068634NIAID NIH HHS UM1 AI069436NIAID NIH HHS UM1 AI069463NIAID NIH HHS UM1 AI069518NIAID NIH HHS UM1 AI069530NIAID NIH HHS UM1 AI106716NICHD NIH HHS HHSN275201800001CNICHD NIH HHS HHSN275201800001I
6 · The paper itself

Abstract

backgroundMalnutrition is highly prevalent in HIV-exposed perinatally uninfected infants (HEUs) increasing the risk of morbidity and mortality throughout the life course. We set out to compare the effect of postnatal exposure to maternal antiretroviral therapy (mART) in breastmilk versus infant Nevirapine prophylaxis (iNVP) on somatic growth of HEUs in the randomized PROMISE trial. METHODS AND

findingsWe randomized 2431 mothers with HIV and their 2444 HEUs from six African countries and India 6-14 days after delivery to mART or iNVP for prevention of breastmilk HIV transmission. The mART regimen contained tenofovir/emtricitabine (99%) plus lopinavir/ritonavir. Infant growth parameters were compared at postnatal week 10, 26, 74 and 104 using World Health Organization (WHO) z-scores for length-for-age (LAZ), weight-for-age (WAZ), and head circumference-for-age (HCAZ). Week 26 LAZ was the primary endpoint measure. Student T-tests compared mean LAZ, WAZ, and HCAZ; estimated mean and 95% confidence interval (CI) are presented. Maternal and infant baseline characteristics were comparable between study arms. The estimated median breastfeeding duration was 70 weeks. After a mean follow-up of 88 weeks, mean LAZ and WAZ were below the WHO reference population mean at all timepoints, whereas mean HCAZ was not. The mART and iNVP arms did not differ for the primary outcome measure of LAZ at week 26 (p-value = 0.39; estimated mean difference (95%CI) of -0.05 (-0.18, 0.07)) or any of the other secondary growth outcome measures or timepoints (all p-values≥0.16). Secondary analyses of the primary outcome measure adjusting for week 0 LAZ and other covariates did not change these results (all p-values≥0.09). However, infants assigned to mART were more likely to have stunting compared to iNVP infants at week 26 (odds ratio (95% CI): 1.28 (1.05, 1.57)).

conclusionsIn HEUs, growth effects from postnatal exposure to mART compared to iNVP were comparable for measures on length, weight and head circumference with no clinically relevant differences between the groups. Despite breastfeeding into the second year of life, length and weight were below reference population means at all ages in both arms. Further investment is needed to optimize postnatal growth of infants born to women with HIV. CLINICAL

trial registrationClinicalTrials.gov number NCT01061151.

Indexed as

Child DevelopmentAdultAnti-Retroviral AgentsFemaleHIV InfectionsHumansInfantMaleMilk, HumanNevirapineAnti-Retroviral AgentsNevirapine

Identifiers

PMID34415933
PMCPMC8378741
OpenAlexW3195208351

What OpenQuestion holds

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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.