{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:23:38Z","timestamp":1760955818761,"version":"build-2065373602"},"reference-count":37,"publisher":"BMJ","issue":"4","funder":[{"name":"the Total Foundation."},{"DOI":"10.13039\/501100005416","name":"the Research Council of Norway","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005416","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001713","name":"the European Developing Countries Clinical Trials Partnership","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"crossref"}]},{"name":"the French National Institute of Health and Medical Research - National Agency for Research on AIDS and Viral Hepatitis (Inserm-ANRS),"},{"name":"Quota Scheme Norway"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,2,14]]},"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We have assessed HIV-1 disease progression among HIV-1-positive mothers in relation to duration of any or exclusive breast feeding in the context of ANRS 12174 trial.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The analysis was completed on 203, 212, 272 and 529 HIV-1-positive and lactating mothers with CD4 count &gt;350 cells\/\u00b5L from Burkina Faso, South Africa, Uganda and Zambia, respectively. The trial compared lamivudine and lopinavir\/ritonavir as a peri-exposure prophylaxis during a 50-week follow-up time. A multiple logistic regression model was run with the mothers\u2019 weight, CD4 count and HIV-1 viral load as separate dependent variables, then combined into a dependent composite endpoint called HIV-1 disease progression where HIV-1 viral load was replaced by the HIV-1 clinical stage. Exclusive or predominant breast feeding (EPBF) and any breastfeeding duration were the key explanatory variables.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In the adjusted model, the associations between EPBF duration and weight change, CD4 cell count and the HIV-1 viral load were consistently insignificant. The CD4 cell count was associated with a significantly higher mothers\u2019 body mass index (BMI; a mean increase of 4.9 (95% CI 2.1 to 7.7) CD4 cells\/\u00b5L per each additional kilogram per square metre of BMI) and haemoglobin concentration (19.4 (95% CI 11.4 to 27.4) CD4 cells\/\u00b5L per each additional gram per decilitre of haemoglobin concentration). There was no significant association between EPBF duration and HIV-1 disease progression. A higher education level was a factor associated with a slower HIV-1 disease progression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Breast feeding was not a risk factor for a faster progression of HIV-1 disease in mothers of this cohort with a baseline CD4 cell count &gt;350 cells\/\u00b5L.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"NCT0064026\" ext-link-type=\"clintrialgov\" specific-use=\"clinicaltrial post-results\">NCT0064026<\/jats:ext-link>; Post-results.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-019239","type":"journal-article","created":{"date-parts":[[2018,4,6]],"date-time":"2018-04-06T03:08:03Z","timestamp":1522984083000},"page":"e019239","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["HIV-1 disease progression in immune-competent HIV-1-infected and breastfeeding mothers participating in the ANRS 12174 clinical trial in Burkina Faso, South Africa, Uganda and Zambia: a cohort study"],"prefix":"10.1136","volume":"8","clinical-trial-number":[{"clinical-trial-number":"nct0064026","registry":"10.18810\/clinical-trials-gov","type":"postResults"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5356-2598","authenticated-orcid":false,"given":"Eric Nagaonle","family":"Som\u00e9","sequence":"first","affiliation":[{"name":"Centre for International Health, University of Bergen, Bergen, Norway"},{"name":"National Health Research Institute, Centre National pour la Recherche Scientifique et Technologique, Ouagadougou, Burkina Faso"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingunn M S","family":"Engebretsen","sequence":"additional","affiliation":[{"name":"Centre for International Health, University of Bergen, Bergen, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Nagot","sequence":"additional","affiliation":[{"name":"Pathogenesis and Control of Chronic Infections, Universit\u00e9 Montpellier, INSERM, Etablissement francais du sang (EFS), CHU Montpellier, Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas Yelbomkan","family":"Meda","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Centre de Recherche International en Sant\u00e9 (CRIS), University of Ouagadougou, Ouagadougou, Burkina Faso"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roselyne","family":"Vallo","sequence":"additional","affiliation":[{"name":"Pathogenesis and Control of Chronic Infections, Universit\u00e9 Montpellier, INSERM, Etablissement francais du sang (EFS), CHU Montpellier, Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chipepo","family":"Kankasa","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, School of Medicine, University of Zambia, Lusaka, Zambia"},{"name":"University Teaching Hospital, Lusaka, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James K","family":"Tumwine","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mandisa","family":"Singata-Madliki","sequence":"additional","affiliation":[{"name":"Effective Care Research Unit, University of Fort Hare, Alice, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim","family":"Harper","sequence":"additional","affiliation":[{"name":"Effective Care Research Unit, University of Fort Hare, Alice, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G Justus","family":"Hofmeyr","sequence":"additional","affiliation":[{"name":"Effective Care Research Unit, University of Fort Hare, Alice, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Van de Perre","sequence":"additional","affiliation":[{"name":"Pathogenesis and Control of Chronic Infections, Universit\u00e9 Montpellier, INSERM, Etablissement francais du sang (EFS), CHU Montpellier, Montpellier, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thorkild","family":"Tyllesk\u00e4r","sequence":"additional","affiliation":[{"name":"Centre for International Health, University of Bergen, Bergen, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,4,5]]},"reference":[{"unstructured":"UNAIDS. 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