nterventions to prevent mother-to-child transmission in breastfeeding mothers with HIV: a systematic review and meta-analysis of randomized controlled trials

Authors

  • Fangping Xu Jiangxi Maternal and Child Health Hospital, Obstetrical Department, Jiangxi, Nanchang, China
  • Ying Xiong Jiangxi Maternal and Child Health Hospital, Obstetrical Department, Jiangxi, Nanchang, China
  • Min Gu Jiangxi Maternal and Child Health Hospital, Obstetrical Department, Jiangxi, Nanchang, China
  • Lingling Wan Jiangxi Maternal and Child Health Hospital, Obstetrical Department, Jiangxi, Nanchang, China
  • Yun Wang Jiangxi Maternal and Child Health Hospital, Obstetrical Department, Jiangxi, Nanchang, China https://orcid.org/0009-0007-6105-7069

DOI:

https://doi.org/10.1590/

Keywords:

HIV, Prevention, Mother-to-child transmission, Breastfeeding, Systematic review, Meta-analysis

Abstract

This study aimed to systematically review interventions to prevent mother-to-child transmission of HIV during breastfeeding. We conducted a systematic review and meta-analysis using specific criteria to identify randomized controlled trials that focused on pregnant and breastfeeding women living with HIV and their children from birth to 2 years of age. We extensively searched electronic databases, including Web of Science, Scopus, PubMed, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Google Scholar up to October 24, 2023. After screening 3,110 titles and abstracts, we reviewed 306 full texts. Of these, we assessed the quality and risk of bias of fifty-five articles, ultimately identifying seven studies. Four of these studies, which focused on antiretroviral therapy (ART), were included in the meta-analysis. There was little heterogeneity in study methodology and pooled estimates. The postnatal HIV transmission rate was found to be 0.01 (95%CI: 0.00 – 0.02). Therefore, the risk of mother-to-child transmission among breastfeeding mothers with HIV was significantly lower in the intervention groups than in the placebo groups. Analysis of funnel plots and Egger’s test (p = 0.589) showed no evidence of publication bias. In addition to the four articles, two studies compared different ART regimens and one study compared the administration of high-dose vitamin A to the mother or the child. The results suggest that the use of ART significantly reduces the risk of postnatal HIV transmission compared with placebo. However, the effectiveness of different ART regimens or other therapies, including high-dose vitamin A, is unclear.

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Published

2024-08-08

Issue

Section

Review

How to Cite

Xu, F., Xiong, Y., Gu, M., Wan, L., & Wang, Y. (2024). nterventions to prevent mother-to-child transmission in breastfeeding mothers with HIV: a systematic review and meta-analysis of randomized controlled trials. Revista Do Instituto De Medicina Tropical De São Paulo, 66, e45. https://doi.org/10.1590/