HIV-1の伝播に対する母乳育児と配方栄養の効果:ランダム化臨床試験
R Nduati1, G John, D Mbori-Ngacha
1Department of Paediatrics, University of Nairobi, Kenya.
JAMA
|March 7, 2000
まとめ
授乳は,ヒト免疫不全ウイルス1型 (HIV-1) を16.2%の症例で伝播し,ほとんどの感染は早期に発生します. 配方栄養は,乳児のHIV-1フリー生存率を大幅に改善しました.
科学分野:
- 感染症 感染症は感染症です.
- 小児科は小児科です.
- 公衆衛生は公衆衛生である.
背景:
- 授乳によるヒト免疫不全ウイルス1型 (HIV-1) 感染は,特に発展途上国では大きな懸念事項です.
- 母乳感染の正確なリスクと,配粉剤に関連したリスクは不明である.
研究 の 目的:
- 母乳によるHIV-1感染の頻度を定量化するために.
- 哺乳乳乳児と配粉乳児の死亡率とHIV-1-フリー生存率を比較する.
主な方法:
- ケニアのナイロビで,401人のHIV-1陽性母と乳児のペアを対象としたランダム化臨床試験.
- 乳児はランダムに授乳または配方栄養に割り当てられ,追跡期間は24ヶ月でした.
- 主なアウトカムには,乳児のHIV-1感染と死亡が含まれていました.
主要な成果:
- 24ヶ月でHIV-1感染の累積的確率は,授乳グループで36.7%で,配給グループで20.5%であった (P = .001).
- 感染の推定16.2%は母乳感染によるもので,母乳感染による感染は母乳感染による感染の44%を占めた.
- 2年後のHIV-1フリー生存率は,母乳授乳グループ (58.0%) で,栄養食グループ (70.0%) (P = .02) と比較して,著しく低かった.
結論:
- HIV-1の母乳感染は,乳児の16.2%で発生し,主に母乳授乳期の初期に発生しました.
- 母乳代用品の使用は,乳児のHIV-1感染を大幅に減少させ,HIV-1フリー生存率を向上させました.
- 発見は,高流行環境でHIV-1の感染を防ぐために,母乳育児と配方栄養の間のトレードオフを強調しています.
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