Table 2.
Vertical postnatal HIV transmission data (2000–2018) separated by the infant feeding modes (breastfed, mixed-method and PIF-fed infants)*
| Year (country) | Exclusive breast-feeding definition in study | Exclusive breast-feeding | Mixed breast-feeding | PIF feeding | Antiretroviral therapy | Study duration | References | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Incidence/total number of infants in study | % | Incidence/total number of infants in study | % | Incidence/total number of infants in study | % | Incidence/total number of infants in study | % | ||||
| 2000 (South Africa) | No liquids/solids introduced | 15/103 | 14·6 | 69/288 | 24·1 | 29/156 | 18·8 | No | 1 d–3 months | (19) | |
| 2005 (Uganda) | Only breast milk was received with no other concomitant fluid or feed. Infants who were switched to PIF before 4 months were still included in the EBF group | 19/119 | 16 | 10/49 | 20·4 | 4/108 | 3·7 | Short-term courses of zidovudine or nevirapine for mothers | Birth-6 months | (28) | |
| 2005 (Zimbabwe) | No liquids/solids or non-human milk except for vitamins or prescribed medicines for at least 3 months. One lapse in EBF was allowed as long as the non-breast milk item was not non-human milk | 8/156 | 5·1 | PBF 35/490 |
7·1 | Not reported | No | 6 weeks-18 months | (20) | ||
| MBF 156/1414 |
11 | ||||||||||
| 2007 (South Africa) | No liquids/solids except for vitamins or drugs (but up to 3 d of PIF feeding allowed in the EBF group) | 55/362 | 15 | MBF > 14 weeks 89/322, |
27 | 2/287 | 7 | Single-dose nevirapine provided for mothers and infants | 6–26 weeks | (21) | |
| MBF < 14 weeks 61/239 |
26 | ||||||||||
| 2010 (Nigeria) | Not defined | 5/27 | 18·8 | 32/47 | 68 | 11/228 | 4·8 | 231/304 mother and infant/only mother or only infant received ART | 76 | 6 weeks–17 months | (29) |
| 2014 (Tanzania) | Not defined | 43/497 | 8·7 | 6/22 | 27·3 | 4/40 | 10 | 469/561 received chemoprophylaxis | 86 | 4 weeks–18 months | (f) |
| 2014 (Nigeria) | Not defined | 3/94 | 3·2 | 10/63 | 15·9 | 6/426 | 1·4 | 431/583 received ART | 73·9 | 6 weeks-18 months | (23) |
| 2017 (Kenya) | Not defined | 10 364/167 166 | 6·2 | 3600/23 682 | 15·2 | 3672/27 856 | 9·7 | 68 % mother and child or mother only received some form of prophylaxis. 14 % prophylaxis status unknown | Birth-24 months | (31) | |
| 2018 (Cameroon) | No added supplements except vitamins. Feeding options described for the first 3 months only | 11/405 | 2·7 | 3/14 | 21·4 | 25/658 | 3·8 | All mothers received zidovudine | 6 weeks-24 months | (22) | |
| 2018 (Ethiopia) | Not defined | 15/691 | 3·3 | 3/10 | 37·5 | 4/63 | 7·5 | 407/764 mothers on prophylaxis | 53·3 | Birth–18 months | (32) |
| 353/764 mothers on HAART | 46·3 | ||||||||||
| 736/764 infants on prophylaxis | 97·9 | ||||||||||
| 2018 (Nigeria) | Not defined | 1/29 | 3·4 | 0/8 | 0 | 1/7 | 14·3 | 2/44 mother-infant pairs received ART | 95·2 | 1–18 months | (33) |
| Total | n/a | 10 539/169 549 | 6·2 | 4074/26 648 | 15·2 | 3758/29 829 | 12·6 | n/a | n/a | n/a | |
PIF, powdered infant formula; MBF, mixed breast-feeding; PBF, predominantly breast-feeding; EBF, exclusively breast-feeding; EFF, exclusive formula feeding; ART, antiretroviral therapy; HAART, highly active antiretroviral therapy.
*
This review records the incidence in each study of vertical HIV transmission, the total number of infants in the study and the percentage of the transmission rate. It should be noted that some of the included studies began their study from birth, which may not differentiate accurately between congenital and postnatal transmission.