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Transmisión del VIH a través de la lactancia materna: un estudio en Malawi
P G Miotti1, T E Taha, N I Kumwenda
1Department of Epidemiology, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD, USA. pm122m@nih.gov
JAMA
|August 27, 1999
Resumen
El riesgo de transmisión del virus de la inmunodeficiencia humana (VIH) a través de la lactancia materna es mayor en los primeros meses de vida. Este hallazgo es crucial para desarrollar políticas efectivas de alimentación infantil para madres infectadas por el VIH.
Área de la Ciencia:
- La salud de la madre y el niño.
- Epidemiología de las enfermedades infecciosas.
- Política de salud pública política de salud pública.
Sus antecedentes:
- Comprender los riesgos de transmisión del virus de la inmunodeficiencia humana (VIH) a través de la lactancia materna es vital para asesorar a las madres infectadas por el VIH.
- Informar a la política de salud pública requiere datos precisos sobre la transmisión del VIH relacionada con la lactancia materna.
Objetivo del estudio:
- Para cuantificar la frecuencia y el tiempo de transmisión del VIH a través de la leche materna.
- Identificar los factores de riesgo maternos e infantiles asociados con la transmisión del VIH durante la lactancia materna.
Principales métodos:
- Un estudio de cohorte prospectivo se llevó a cabo en Malawi desde 1994 hasta 1997.
- 672 niños VIH-negativos nacidos de madres infectadas por el VIH (sin exposición a medicamentos antirretrovirales) fueron seguidos durante 24 meses.
- Se utilizaron modelos de riesgo proporcional para analizar la incidencia del VIH e identificar los factores de riesgo.
Principales resultados:
- No se produjeron infecciones por VIH después de la interrupción de la lactancia materna; 47 infecciones ocurrieron durante la lactancia materna.
- Las tasas acumuladas de infección por VIH a los 5, 11, 17 y 23 meses fueron del 3,5%, 7,0%, 8,9% y 10,3%, respectivamente.
- Una alta paridad materna y una mayor edad materna se asociaron con un riesgo significativamente menor de transmisión postnatal del VIH.
Conclusiones:
- El mayor riesgo de infección por VIH por la lactancia materna se produce en los primeros meses después del parto.
- Estos hallazgos requieren una cuidadosa consideración al formular pautas de lactancia materna para madres VIH positivas.
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