Early, abrupt weaning did not reduce risk of HIV infection or mortality in breast-fed infants of mothers with HIV

This paper discusses the literature dealing with breast-feeding in women with human immunodeficiency virus (HIV) infection. This review is used to develop a background for a quantitative assessment of factors determining whether breast-feeding or bottle-feeding will result in a lower overall mortality in areas of different HIV prevalence. An algebraic formula is presented that enables calculation of the mortality that would result in any population if the following variables are known or capable of estimation: portion of child-bearing women infected with HIV, portion of newborns infected with HIV at birth, relative mortality of breast-fed and bottle-fed infants that are not HIV infected, and transmissibility of HIV during breast-feeding. The information available for estimating these variables is incomplete. Nevertheless, boundaries can be set for each variable, based on information obtained locally or from the literature, to aid in objective evaluation of the risks of promoting bottle-feeding or breast-feeding in populations with different risk characteristics. Consideration of these factors indicates that the benefits of breast-feeding over bottle-feeding can substantially outweigh any putative risk of HIV transmission during breast-feeding unless the prevalence of HIV infection is quite high or the difference in mortality of breast-fed and bottle-fed infants is very low.

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Analysis of MDR1 Polymorphisms Among HIV-Infected Individuals on ARV Therapy from Western India

10.21203/rs.3.rs-51053/v1 ◽

2020 ◽

Author(s):

HariOm Singh ◽

Dharmesh Samani ◽

Vijay Chauware ◽

T.N Dhole

Keyword(s):

Treatment Outcome ◽

Hiv Infection ◽

Ethnic Disparities ◽

Combined Effect ◽

Western India ◽

Infected People ◽

Pcr Rflp ◽

Reduce Risk

Abstract Background: MDR1 is involved in the transport of numerous drugs. Polymorphism of MDR1 is linked with the treatment outcome. ARV regimen is being used to manage the progression of HIV infection. Ethnic disparities have been observed in the distribution of MDR1 genotypes. Methods: MDR1 polymorphism (1236 C/T, 3435 C/T) was genotyped in 34 individuals with ARV-associated hepatotoxicity, 131 HIV-infected, and one-fifty-five healthy by utilization of PCR-RFLP. Results: Haplotype TC exposed the greater risk for hepatotoxicity severity when compared between individuals with hepatotoxicity and HIV infected (OR=1.96, P=0.06). While haplotypes TT and CC bared a reduce risk for hepatotoxicity severity (OR= 0.16, P=0.006; OR= 0.46, P=0.06). Haplotype TT and CC displayed a decrease risk of hepatotoxicity severity while compared between individuals with hepatotoxicity and healthy (OR=0.09, P=0.003; OR=0.34, P=0.03). A higher occurrence of MDR1 1236TT genotype was seen among patients with hepatotoxicity who consumed alcohol (28.6% versus 14.8%, OR=1.50). In patients with hepatotoxicity taking nevirapine, there was an increased incidence of MDR1 1236TT genotype in contrast with efavirenz (21.7% versus 9.1%, OR=2.11). In HIV-infected people taking nevirapine, MDR1 1236CT, 1236TT genotypes found to be increased compared with efavirenz (43.7% versus 33.3%, OR=1.66; 12.6% versus 8.3%, OR=1.96). A higher occurrence of MDR1 1236TT genotype has happened in hepatotoxicity cases having both alcohol and nevirapine (40.0% versus 16.67%, OR=2.21). Conclusion: MDR1 haplotypes may have an influence on the severity of hepatotoxicity. Individual utilizing nevirapine and alcohol with MDR1 1236TT and 3435CT genotypes may have combined effect on vulnerability of severity of hepatotoxicity and progression of HIV infection

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