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Getting to under 1% vertical HIV transmission: lessons from a breastfeeding cohort in South Africa

We report here on the transmission of HIV in a cohort of breastfeeding infants enrolled in a prevention of mother to child HIV transmission (PMTCT) programme at the epicentre of the HIV pandemic. South Africa implemented option B+ for PMTCT in 2015. Between 2013 and 2018, we enrolled 1219 infants bo...

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Autores principales: Daniels, Brodie, Spooner, Elizabeth, Coutsoudis, Anna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9490562/
https://www.ncbi.nlm.nih.gov/pubmed/36130776
http://dx.doi.org/10.1136/bmjgh-2022-009927
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author Daniels, Brodie
Spooner, Elizabeth
Coutsoudis, Anna
author_facet Daniels, Brodie
Spooner, Elizabeth
Coutsoudis, Anna
author_sort Daniels, Brodie
collection PubMed
description We report here on the transmission of HIV in a cohort of breastfeeding infants enrolled in a prevention of mother to child HIV transmission (PMTCT) programme at the epicentre of the HIV pandemic. South Africa implemented option B+ for PMTCT in 2015. Between 2013 and 2018, we enrolled 1219 infants born to HIV positive women into a non-inferiority trial assessing the current cotrimoxazole prophylaxis guidelines for HIV-exposed uninfected infants. Breastfeeding mothers and infants were enrolled and followed up at one of two clinics in eThekwini, KwaZulu-Natal, until 12 months of age. During the study period, 8 infants seroconverted (<1% transmission); these were likely four birth transmissions and four breastfeeding transmissions. It is critical in the post option B era to assess the reasons for vertical transmission of HIV to enable healthcare workers and policy makers to provide strategies to mitigate future infections. This report details the possible contributors to vertical transmission in this cohort and highlights the continued strategies that should be employed to further our goal towards reaching the elimination of mother to child HIV transmission
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spelling pubmed-94905622022-09-22 Getting to under 1% vertical HIV transmission: lessons from a breastfeeding cohort in South Africa Daniels, Brodie Spooner, Elizabeth Coutsoudis, Anna BMJ Glob Health Practice We report here on the transmission of HIV in a cohort of breastfeeding infants enrolled in a prevention of mother to child HIV transmission (PMTCT) programme at the epicentre of the HIV pandemic. South Africa implemented option B+ for PMTCT in 2015. Between 2013 and 2018, we enrolled 1219 infants born to HIV positive women into a non-inferiority trial assessing the current cotrimoxazole prophylaxis guidelines for HIV-exposed uninfected infants. Breastfeeding mothers and infants were enrolled and followed up at one of two clinics in eThekwini, KwaZulu-Natal, until 12 months of age. During the study period, 8 infants seroconverted (<1% transmission); these were likely four birth transmissions and four breastfeeding transmissions. It is critical in the post option B era to assess the reasons for vertical transmission of HIV to enable healthcare workers and policy makers to provide strategies to mitigate future infections. This report details the possible contributors to vertical transmission in this cohort and highlights the continued strategies that should be employed to further our goal towards reaching the elimination of mother to child HIV transmission BMJ Publishing Group 2022-09-20 /pmc/articles/PMC9490562/ /pubmed/36130776 http://dx.doi.org/10.1136/bmjgh-2022-009927 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Practice
Daniels, Brodie
Spooner, Elizabeth
Coutsoudis, Anna
Getting to under 1% vertical HIV transmission: lessons from a breastfeeding cohort in South Africa
title Getting to under 1% vertical HIV transmission: lessons from a breastfeeding cohort in South Africa
title_full Getting to under 1% vertical HIV transmission: lessons from a breastfeeding cohort in South Africa
title_fullStr Getting to under 1% vertical HIV transmission: lessons from a breastfeeding cohort in South Africa
title_full_unstemmed Getting to under 1% vertical HIV transmission: lessons from a breastfeeding cohort in South Africa
title_short Getting to under 1% vertical HIV transmission: lessons from a breastfeeding cohort in South Africa
title_sort getting to under 1% vertical hiv transmission: lessons from a breastfeeding cohort in south africa
topic Practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9490562/
https://www.ncbi.nlm.nih.gov/pubmed/36130776
http://dx.doi.org/10.1136/bmjgh-2022-009927
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