Effect of Postnatal HIV Treatment on Clinical Mastitis and Breast Inflammation in HIV-Infected Breast-feeding Women

Sabrina Zadrozny, Daniel Westreich, Michael G. Hudgens, Charles Chasela, Denise J. Jamieson, Francis Martinson, Chifundo Zimba, Gerald Tegha, Irving Hoffman, William C. Miller, Brian W. Pence, Caroline C. King, Athena P. Kourtis, Wezi Msungama, Charles van der Horst, the BAN Study Team

Research output: Research - peer-reviewArticle

Abstract

Background: The relationship between mastitis and antiretroviral therapy among HIV-positive, breast-feeding women is unclear. Methods: In the Breastfeeding, Antiretrovirals, and Nutrition (BAN) study, conducted in Lilongwe, Malawi, 2369 mother-infant pairs were randomized to a nutritional supplement group and to one of three treatment groups: maternal antiretroviral therapy (ART), infant nevirapine (NVP) or standard of care for 24 weeks of exclusive breast-feeding and 4 weeks of weaning. Among 1472 HIV-infected women who delivered live infants between 2004 and 2007, we estimated cumulative incidence functions and sub-distribution hazard ratios (HR) of mastitis or breast inflammation comparing women in maternal ART (n = 487) or infant nevirapine (n = 492) groups to the standard of care (n = 493). Nutritional supplement groups (743 took, 729 did not) were also compared. Results: Through 28-weeks post-partum, 102 of 1472 women experienced at least one occurrence of mastitis or breast inflammation. The 28-week risk was higher for maternal ART (risk difference (RD) 4.5, 95% confidence interval (CI) 0.9, 8.1) and infant NVP (RD 3.6, 95% CI 0.3, 6.9) compared to standard of care. The hazard of late-appearing mastitis or breast inflammation (from week 5–28) was also higher for maternal ART (HR 6.7, 95% CI 2.0, 22.6) and infant NVP (HR 5.1, 95% CI 1.5, 17. 5) compared to the standard of care. Conclusions: Mastitis or breast inflammation while breast-feeding is a possible side effect for women taking prophylactic ART and women whose infants take NVP, warranting additional research in the context of postnatal HIV transmission.

LanguageEnglish (US)
Pages134-143
Number of pages10
JournalPaediatric and Perinatal Epidemiology
Volume31
Issue number2
DOIs
StatePublished - Mar 1 2017

Fingerprint

Mastitis
Breast Feeding
Breast
HIV
Inflammation
Therapeutics
Nevirapine
Mothers
Standard of Care
Confidence Intervals
Malawi
Weaning
Incidence
Research

Keywords

  • breast-feeding
  • human immunodeficiency virus
  • infant nevirapine
  • Mastitis
  • prophylactic antiretroviral therapy

ASJC Scopus subject areas

  • Epidemiology
  • Pediatrics, Perinatology, and Child Health

Cite this

Zadrozny, S., Westreich, D., Hudgens, M. G., Chasela, C., Jamieson, D. J., Martinson, F., ... the BAN Study Team (2017). Effect of Postnatal HIV Treatment on Clinical Mastitis and Breast Inflammation in HIV-Infected Breast-feeding Women. Paediatric and Perinatal Epidemiology, 31(2), 134-143. DOI: 10.1111/ppe.12337

Effect of Postnatal HIV Treatment on Clinical Mastitis and Breast Inflammation in HIV-Infected Breast-feeding Women. / Zadrozny, Sabrina; Westreich, Daniel; Hudgens, Michael G.; Chasela, Charles; Jamieson, Denise J.; Martinson, Francis; Zimba, Chifundo; Tegha, Gerald; Hoffman, Irving; Miller, William C.; Pence, Brian W.; King, Caroline C.; Kourtis, Athena P.; Msungama, Wezi; van der Horst, Charles; the BAN Study Team.

In: Paediatric and Perinatal Epidemiology, Vol. 31, No. 2, 01.03.2017, p. 134-143.

Research output: Research - peer-reviewArticle

Zadrozny, S, Westreich, D, Hudgens, MG, Chasela, C, Jamieson, DJ, Martinson, F, Zimba, C, Tegha, G, Hoffman, I, Miller, WC, Pence, BW, King, CC, Kourtis, AP, Msungama, W, van der Horst, C & the BAN Study Team 2017, 'Effect of Postnatal HIV Treatment on Clinical Mastitis and Breast Inflammation in HIV-Infected Breast-feeding Women' Paediatric and Perinatal Epidemiology, vol 31, no. 2, pp. 134-143. DOI: 10.1111/ppe.12337
Zadrozny S, Westreich D, Hudgens MG, Chasela C, Jamieson DJ, Martinson F et al. Effect of Postnatal HIV Treatment on Clinical Mastitis and Breast Inflammation in HIV-Infected Breast-feeding Women. Paediatric and Perinatal Epidemiology. 2017 Mar 1;31(2):134-143. Available from, DOI: 10.1111/ppe.12337
Zadrozny, Sabrina ; Westreich, Daniel ; Hudgens, Michael G. ; Chasela, Charles ; Jamieson, Denise J. ; Martinson, Francis ; Zimba, Chifundo ; Tegha, Gerald ; Hoffman, Irving ; Miller, William C. ; Pence, Brian W. ; King, Caroline C. ; Kourtis, Athena P. ; Msungama, Wezi ; van der Horst, Charles ; the BAN Study Team. / Effect of Postnatal HIV Treatment on Clinical Mastitis and Breast Inflammation in HIV-Infected Breast-feeding Women. In: Paediatric and Perinatal Epidemiology. 2017 ; Vol. 31, No. 2. pp. 134-143
@article{09d22733d9fa4764a78a4e3496843da4,
title = "Effect of Postnatal HIV Treatment on Clinical Mastitis and Breast Inflammation in HIV-Infected Breast-feeding Women",
abstract = "Background: The relationship between mastitis and antiretroviral therapy among HIV-positive, breast-feeding women is unclear. Methods: In the Breastfeeding, Antiretrovirals, and Nutrition (BAN) study, conducted in Lilongwe, Malawi, 2369 mother-infant pairs were randomized to a nutritional supplement group and to one of three treatment groups: maternal antiretroviral therapy (ART), infant nevirapine (NVP) or standard of care for 24 weeks of exclusive breast-feeding and 4 weeks of weaning. Among 1472 HIV-infected women who delivered live infants between 2004 and 2007, we estimated cumulative incidence functions and sub-distribution hazard ratios (HR) of mastitis or breast inflammation comparing women in maternal ART (n = 487) or infant nevirapine (n = 492) groups to the standard of care (n = 493). Nutritional supplement groups (743 took, 729 did not) were also compared. Results: Through 28-weeks post-partum, 102 of 1472 women experienced at least one occurrence of mastitis or breast inflammation. The 28-week risk was higher for maternal ART (risk difference (RD) 4.5, 95% confidence interval (CI) 0.9, 8.1) and infant NVP (RD 3.6, 95% CI 0.3, 6.9) compared to standard of care. The hazard of late-appearing mastitis or breast inflammation (from week 5–28) was also higher for maternal ART (HR 6.7, 95% CI 2.0, 22.6) and infant NVP (HR 5.1, 95% CI 1.5, 17. 5) compared to the standard of care. Conclusions: Mastitis or breast inflammation while breast-feeding is a possible side effect for women taking prophylactic ART and women whose infants take NVP, warranting additional research in the context of postnatal HIV transmission.",
keywords = "breast-feeding, human immunodeficiency virus, infant nevirapine, Mastitis, prophylactic antiretroviral therapy",
author = "Sabrina Zadrozny and Daniel Westreich and Hudgens, {Michael G.} and Charles Chasela and Jamieson, {Denise J.} and Francis Martinson and Chifundo Zimba and Gerald Tegha and Irving Hoffman and Miller, {William C.} and Pence, {Brian W.} and King, {Caroline C.} and Kourtis, {Athena P.} and Wezi Msungama and {van der Horst}, Charles and {the BAN Study Team}",
year = "2017",
month = "3",
doi = "10.1111/ppe.12337",
volume = "31",
pages = "134--143",
journal = "Paediatric and Perinatal Epidemiology",
issn = "0269-5022",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Effect of Postnatal HIV Treatment on Clinical Mastitis and Breast Inflammation in HIV-Infected Breast-feeding Women

AU - Zadrozny,Sabrina

AU - Westreich,Daniel

AU - Hudgens,Michael G.

AU - Chasela,Charles

AU - Jamieson,Denise J.

AU - Martinson,Francis

AU - Zimba,Chifundo

AU - Tegha,Gerald

AU - Hoffman,Irving

AU - Miller,William C.

AU - Pence,Brian W.

AU - King,Caroline C.

AU - Kourtis,Athena P.

AU - Msungama,Wezi

AU - van der Horst,Charles

AU - the BAN Study Team

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Background: The relationship between mastitis and antiretroviral therapy among HIV-positive, breast-feeding women is unclear. Methods: In the Breastfeeding, Antiretrovirals, and Nutrition (BAN) study, conducted in Lilongwe, Malawi, 2369 mother-infant pairs were randomized to a nutritional supplement group and to one of three treatment groups: maternal antiretroviral therapy (ART), infant nevirapine (NVP) or standard of care for 24 weeks of exclusive breast-feeding and 4 weeks of weaning. Among 1472 HIV-infected women who delivered live infants between 2004 and 2007, we estimated cumulative incidence functions and sub-distribution hazard ratios (HR) of mastitis or breast inflammation comparing women in maternal ART (n = 487) or infant nevirapine (n = 492) groups to the standard of care (n = 493). Nutritional supplement groups (743 took, 729 did not) were also compared. Results: Through 28-weeks post-partum, 102 of 1472 women experienced at least one occurrence of mastitis or breast inflammation. The 28-week risk was higher for maternal ART (risk difference (RD) 4.5, 95% confidence interval (CI) 0.9, 8.1) and infant NVP (RD 3.6, 95% CI 0.3, 6.9) compared to standard of care. The hazard of late-appearing mastitis or breast inflammation (from week 5–28) was also higher for maternal ART (HR 6.7, 95% CI 2.0, 22.6) and infant NVP (HR 5.1, 95% CI 1.5, 17. 5) compared to the standard of care. Conclusions: Mastitis or breast inflammation while breast-feeding is a possible side effect for women taking prophylactic ART and women whose infants take NVP, warranting additional research in the context of postnatal HIV transmission.

AB - Background: The relationship between mastitis and antiretroviral therapy among HIV-positive, breast-feeding women is unclear. Methods: In the Breastfeeding, Antiretrovirals, and Nutrition (BAN) study, conducted in Lilongwe, Malawi, 2369 mother-infant pairs were randomized to a nutritional supplement group and to one of three treatment groups: maternal antiretroviral therapy (ART), infant nevirapine (NVP) or standard of care for 24 weeks of exclusive breast-feeding and 4 weeks of weaning. Among 1472 HIV-infected women who delivered live infants between 2004 and 2007, we estimated cumulative incidence functions and sub-distribution hazard ratios (HR) of mastitis or breast inflammation comparing women in maternal ART (n = 487) or infant nevirapine (n = 492) groups to the standard of care (n = 493). Nutritional supplement groups (743 took, 729 did not) were also compared. Results: Through 28-weeks post-partum, 102 of 1472 women experienced at least one occurrence of mastitis or breast inflammation. The 28-week risk was higher for maternal ART (risk difference (RD) 4.5, 95% confidence interval (CI) 0.9, 8.1) and infant NVP (RD 3.6, 95% CI 0.3, 6.9) compared to standard of care. The hazard of late-appearing mastitis or breast inflammation (from week 5–28) was also higher for maternal ART (HR 6.7, 95% CI 2.0, 22.6) and infant NVP (HR 5.1, 95% CI 1.5, 17. 5) compared to the standard of care. Conclusions: Mastitis or breast inflammation while breast-feeding is a possible side effect for women taking prophylactic ART and women whose infants take NVP, warranting additional research in the context of postnatal HIV transmission.

KW - breast-feeding

KW - human immunodeficiency virus

KW - infant nevirapine

KW - Mastitis

KW - prophylactic antiretroviral therapy

UR - http://www.scopus.com/inward/record.url?scp=85013321916&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85013321916&partnerID=8YFLogxK

U2 - 10.1111/ppe.12337

DO - 10.1111/ppe.12337

M3 - Article

VL - 31

SP - 134

EP - 143

JO - Paediatric and Perinatal Epidemiology

T2 - Paediatric and Perinatal Epidemiology

JF - Paediatric and Perinatal Epidemiology

SN - 0269-5022

IS - 2

ER -