Feeding Options and Antiretroviral Prophylaxis among Exposed Infants in Bida, North Central Nigeria

Ogedengbe Sunday Oladokun^1, , Ogedengbe Dorcas Talatu², Inyinbor Henry Eromosele¹, Omosigho Omoruyi Pius¹, Akobi Oliver Adeymi¹, Emumwen Evbaziegbere Gideon¹, Mohammed Kudu Sheu¹, Eze Edith Chinwe³, Oladejo Olayinka Paul⁴, Uzoigwe Eunice Ogochukwu¹, Abayomi Rachael Oluwafunmilayo¹, Akpabio Nse Sunday⁵, Salami Abubakar¹ and Okorie Eucheria¹

¹Department of Medical Microbiology, Federal Medical Centre Bida, Niger State, Nigeria

²Department of Nursing Services, Federal Medical Centre Bida, Niger State, Nigeria

³Department of Paediatrics Federal Medical Centre Bida, Niger State, Nigeria

⁴Department of Chemical Pathology Federal Medical Centre Bida, Niger State, Nigeria

⁵Department of Haematology Federal Medical Centre Bida, Niger State, Nigeria

Cite this paper:
Ogedengbe Sunday Oladokun, Ogedengbe Dorcas Talatu, Inyinbor Henry Eromosele, Omosigho Omoruyi Pius, Akobi Oliver Adeymi, Emumwen Evbaziegbere Gideon, Mohammed Kudu Sheu, Eze Edith Chinwe, Oladejo Olayinka Paul, Uzoigwe Eunice Ogochukwu, Abayomi Rachael Oluwafunmilayo, Akpabio Nse Sunday, Salami Abubakar and Okorie Eucheria. Feeding Options and Antiretroviral Prophylaxis among Exposed Infants in Bida, North Central Nigeria. American Journal of Epidemiology and Infectious Disease. 2015; 3(2):32-35. doi: 10.12691/ajeid-3-2-3

Abstract

Background: Breastfeeding is a major health promoting factor in infants and children in developing countries, but the risk of mother-to-child transmission (MTCT) of HIV by this route is challenging traditional and health policies in low resource countries. Aims: The aim of the study is to determine the effect of feeding options and infant antiretroviral prophylaxis on transmission of HIV in Bida North Central Nigeria. Patients and methods: we reviewed a total of Four hundred and fourteen (414) HIV exposed infants whose dried blood spot (DBS) samples were taken for DNA PCR test between May 2011 and July 2013 and whose parents are on antiretroviral therapy and for whom a complete set of records were available. Results: The most prevalent feeding option was mixed feeding 250(60.4%) followed by exclusive breastfeeding 84(20.3%) and exclusive formula feeding 80(19.3%). The HIV transmission rate is higher among mixed feeding 17.6% followed by exclusive breastfeeding 7.1% and exclusive formula feeding 5.0%. HIV transmission rate of 6.0% was observed for infants that were on antiretroviral prophylaxis and 43.6% for infants who were not on antiretroviral prophylaxis. Conclusion: The study shows the benefits of exclusive formula feeding and the intake of antiretroviral prophylaxis in reducing HIV transmission through breastfeeding.

Keywords:
antiretroviral prophylaxis HIV breast-fed infants

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	De Cock KM, Fowler MG, Mercier E, et al. Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice. JAMA 2000; 283:1175-1182.
[2]	Sperling RS, Shapiro DE, Coombs RW, et al. Maternal viral load, zidovudine treatment, and the risk of transmission of human immunodeficiency virus type 1 from mother to infant. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. N Engl J Med 1996; 335:1621-1629.
[3]	UNAIDS: 2010 Report on the Global AIDS Epidemic. Geneva: UNAIDS; 2010.
[4]	UNAIDS/WHO. AIDS Epidemic Update. December 2008. Geneva: UNAIDS; 2008.
[5]	UNICEF. State of the World's Children 2008. New York: UNICEF; 2008.
[6]	UNAIDS: Unified Budget Results and Accountability Framework (UBRAF) 2012-2015.
[7]	Gray GE, Saloojee H. Breast-feeding, antiretroviral prophylaxis, and HIV. New Engl J Med 2008; 359 (2): 189-191.
[8]	Coutsoudis, A. Breast-feeding and HIV transmission. Nutr Res Rev 2001; 14:191-206.
[9]	Phadke MA, Gadgil B, Bharucha KE, et al. Replacement-fed infants born to HIV- infected mothers in India have a high early postpartum rate of hospitalization. J Nutrition 2003; 133: 3153-3157.
[10]	Mbari–Ngacha D, Nduati R, John G, et al. Morbidity and mortality in breast-fed and formula–fed infants of HIV–1 infected women. A randomized clinical trial. JAMA 2001; 286: 2413-2420.
[11]	Iliff PJ, Piwoz EG, Tavengwa NV, et al. Early exclusive breast-feeding reduces the risk of postnatal HIV–1 transmission and increases HIV–free survival. AIDS 2005; 19 (7): 641-652.
[12]	Coovadia HM, Rollins NC, Bland RM. Mother to child transmission of HIV–1 infection during exclusive breast-feeding in the first 6 months of life: an intervention cohort study. Lancet 2007; 369 (9567): 1107-1116.
[13]	Kuhn L, Sinkala M, Kankasa C, et al. High uptake of Exclusive Breast-feeding and Reduced Early post–natal HIV Transmission. Plos One 2007; 2 (12): e1363.
[14]	WHO (2013, June) 'Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: Recommendations for a public health approach
[15]	Lehman DA, Farquhar C. Biological mechanisms of vertical human immunodeficiency virus (HIV-1) transmission. Rev Med Virol. 2007;17: 381-403.
[16]	World Health Organization. HIV Transmission through Breastfeeding. WHO Geneva 2007.[World Health Organization].
[17]	Van de Perre P, Simonon A, Msellati P, et al. Postnatal transmission of human immunodeficiency virus type 1 from mother to infant. A prospective cohort study in Kigali, Rwanda. N Engl J Med. 1991;325:593-8.
[18]	Rousseau CM, Nduati RW, Richardson BA, John-Stewart GC, Mbori-Ngacha DA, Kreiss JK, Overbaugh J. Association of levels of HIV-1-infected breast milk cells and risk of mother-to-child transmission. J Infect Dis. 2004;190:1880-8.
[19]	Koulinska IN, Villamor E, Chaplin B, Msamanga G, Fawzi W, Renjifo B, Essex M. Transmission of cell-free and cell-associated HIV-1 through breast-feeding. J Acquir Immune Defic Syndr. 2006;41:93-9.
[20]	Anoje C, Aiyenigba B, Suzuki C, Badru T, Akpoigbe K, Odo M, et al. Reducing mother-to-child transmission of HIV: findings from an early infant diagnosis program in south-south region of Nigeria. BMC Public Health 2012, 12:184.
[21]	Torpey K, Kabaso M, Weaver MA, et al.: Infant Feeding Options, Other Non-chemo prophylactic Factors and Mother-to-Child Transmission of HIV in Zambia. J Int Assoc Physicians AIDS Care (Chic) 2011, in press.
[22]	The Petra Study Team: Efficacy of three short-course regimens of zidovudine and lamivudine in preventing early and late transmission of HIV-1 from mother to child in Tanzania, South Africa, and Uganda (Petra study): a randomised, double- blind, placebo-controlled trial. Lancet 2002; 359(9313):1178-1186.
[23]	Lallemant M, Jourdain G, Le Coeu S, et al. Single-dose perinatal Nevirapine plus standard zidovudine to prevent mother-to-child transmission of HIV-1 in Thailand. N Engl J Med 2004; 351:217-228.
[24]	Guay LA, Musoke P, Fleming T, et al.: Intrapartum and neonatal single-dose Nevirapine compared with Zidovudine for prevention of mother-to-child transmission of HIV-1 in Kampala, Uganda: HIVNET 012 randomised trial. Lancet 1999; 354:795-802.
[25]	Digsu Negese Koye and Berihun Megabiaw Zeleke. Mother-to-child transmission of HIV and its predictors among HIV – exposed infants at a PMTCT clinic in north west Ethiopia. BMC Public Health 2013; 13:398.
[26]	Ugochukwu EF and Kalu SO. Early Infant Diagnosis of HIV Infection in South eastern Nigeria; Prevalence of HIV Infection Among HIV-Exposed Babies. WAJM 2010; Vol.29, No1.
[27]	WHO Collaboration Study Team on the Role of Breast feeding on the prevention of infant mortality. Effect of breast feeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. Lancet 2000; 355:451-455.
[28]	Stringer JS, Sinkala M, Maclean CC, Levy J, Kankasa C, Degroot A, et al. Effectiveness of a city-wide program to prevent mother-to-child HIV transmission in Lusaka, Zambia. AIDS 2005; 19:1309-1315.
[29]	Mnyani C, McIntyre J, Struthers H, et al.: Reducing PMTCT in practice: results from a successful model of a PMTCT program in a high prevalence HIV urban setting. In Abstract #TUPEC048. Presented at: 5th IAS Conference on HIV Pathogenesis, Treatment and Prevention. Cape Town, South Africa; 2009.