Abstract

Objective: To compare the HIV free survival and morbidity of breast- and formula-fed infants and young children of HIV infected women in the prevention of mother to child HIV transmission program. Methods: Retrospective cohort study designs were employed from September 12, 2008 to February 28, 2014 to compare free HIV survival of exposed infants and young children whose age is < 18 months and were on breast-fed and formula-fed. Data were retrieved from 857 randomly selected study subjects (291 formula-fed and 566 breast-fed infants and young children). Morbidity and HIV infection (the counterpart of HIV-free survival) in the two feeding modalities were compared by using Kaplan-Meier time-to-event methods and log rank test was used to compare HIV free survival between the two groups. Cox regression analysis was employed to assess the independent predictors. Results: Overall probability of HIV free survival in formula-fed infants and young children was significantly higher than breast-fed infants and young children (log rank test statistics = 6.13, df = 1, P = 0.013). Breast-fed infants and young children had four (adjusted HR = 3.8, 95% CI 1.3–11.1) times higher risks to acquire HIV infection as compared to formula-fed infants and young children. Mothers who didn’t use any prevention of mother to child transmission of HIV intervention had five fold risk to transmit HIV infection to their infants than their counterparts (adjusted HR = 4.8, 95%CI 1.1–22.5). There was no statistically significant difference in the risk of developing any types of morbidity between the two groups. Conclusions: The 18 months cumulative likelihood of HIV free survival was significantly lower in the breast-fed infants and young children as compared to formula-fed infants and young children.

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