Antiretroviral Drug Concentrations in Breastmilk, Maternal HIV Viral Load, and HIV Transmission to the Infant: Results From the BAN Study

Davis, Nicole L.; Corbett, Amanda; Kaullen, Josh D.; Nelson, Julie A.; Chasela, Charles; Sichali, Dorothy; Hudgens, Michael G.; Miller, William C.; Jamieson, Denise J.; Kourtis, Athena P.

doi:10.1097/qai.0000000000001941

Cited by 4 publications

(1 citation statement)

References 19 publications

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“…Rigorous donor screening is not enough; the milk itself must be tested to ensure it is safe for the fragile infants it is destined to feed. (30)(31)(32)(33) The slightest error could be harmful or fatal for premature babies in Neonatal Intensive Care Units (NICUs). The possible long-term effects are myriad.…”

Section: It Is Not Appropriate To Extrapolate Data From Pasteurized Human Milk Studies To Human Milk Sterilized By a Different Processmentioning

confidence: 99%

The Importance of Data in an Exclusive Human Milk Diet: Key Concepts and Points of Consideration

Goldstein

2021

Neonatology Today

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Data is a term that is not hard to define but is difficult to describe. We recognize data for what it is but fail to understand how to interpret it. In the interest of qualifying data and preserving effort, more rigorous challenges to data are often put aside to qualify or validate the effort." "Lack of statistical power may lead to incorrect conclusions, but overpowered studies may invariably find a "statistically" significant finding with no clinical utility. (12)" 69 NEONATOLOGY TODAYtwww.NeonatologyToday.nettSeptember 2021 Disclosures: There are no relevant disclosures identified.

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Section: It Is Not Appropriate To Extrapolate Data From Pasteurized Human Milk Studies To Human Milk Sterilized By a Different Processmentioning

confidence: 99%

The Importance of Data in an Exclusive Human Milk Diet: Key Concepts and Points of Consideration

Goldstein

2021

Neonatology Today

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Human Immunodeficiency Virus and Breastfeeding

Powers,

Kihanga,

Cranmer

2024

Clinics in Perinatology

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Association between social psychological status and efavirenz and nevirapine plasma concentration among HIV patients in Kenya

Ngayo

Oluka

Bulimo

et al. 2021

Sci Rep

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HIV-related stigma, lack of disclosure and social support are still hindrances to HIV testing, care, and prevention. We assessed the association of these social-psychological statuses with nevirapine (NVP) and efavirenz (EFV) plasma concentrations among HIV patients in Kenya. Blood samples were obtained from 254 and 312 consenting HIV patients on NVP- and EFV-based first-line antiretroviral therapy (ART), respectively, and a detailed structured questionnaire was administered. The ARV plasma concentration was measured by liquid chromatography-tandem mass spectrometry (LC–MS/MS). There were 68.1% and 65.4% of the patients on NVP and EFV, respectively, who did not feel guilty for being HIV positive. The disclosure rates were approximately 96.1% and 94.6% of patients on NVP and EFV, respectively. Approximately 85% and 78.2% of patients on NVP and EFV, respectively, received social support as much as needed. There were 54.3% and 14.2% compared to 31.7% and 4.5% patients on NVP and EFV, respectively, with supratherapeutic and suboptimal plasma concentrations. Multivariate quantile regression analysis showed that feeling guilty for being HIV positive was associated with increased 954 ng/mL NVP plasma concentrations (95% CI 192.7 to 2156.6; p = 0.014) but not associated with EFV plasma concentrations (adjusted β = 347.7, 95% CI = − 153.4 to 848.7; p = 0.173). Feeling worthless for being HIV positive was associated with increased NVP plasma concentrations (adjusted β = 852, 95% CI = 64.3 to 1639.7; p = 0.034) and not with EFV plasma concentrations (adjusted β = − 143.3, 95% CI = − 759.2 to 472.5; p = 0.647). Being certain of telling the primary sexual partner about HIV-positive status was associated with increased EFV plasma concentrations (adjusted β 363, 95% CI, 97.9 to 628.1; p = 0.007) but not with NVP plasma concentrations (adjusted β = 341.5, 95% CI = − 1357 to 2040; p = 0.692). Disclosing HIV status to neighbors was associated with increased NVP plasma concentrations (adjusted β = 1731, 95% CI = 376 to 3086; p = 0.012) but not with EFV plasma concentrations (adjusted β = − 251, 95% CI = − 1714.1 to 1212.1; p = 0.736). Obtaining transportation to the hospital whenever needed was associated with a reduction in NVP plasma concentrations (adjusted β = − 1143.3, 95% CI = − 1914.3 to − 372.4; p = 0.004) but not with EFV plasma concentrations (adjusted β = − 6.6, 95% CI = − 377.8 to 364.7; p = 0.972). HIV stigma, lack disclosure and inadequate social support are still experienced by HIV-infected patients in Kenya. A significant proportion of patients receiving the NVP-based regimen had supra- and subtherapeutic plasma concentrations compared to EFV. Social-psychological factors negatively impact adherence and are associated with increased NVP plasma concentration compared to EFV.

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Antiretroviral Drug Concentrations in Breastmilk, Maternal HIV Viral Load, and HIV Transmission to the Infant: Results From the BAN Study

Cited by 4 publications

References 19 publications

The Importance of Data in an Exclusive Human Milk Diet: Key Concepts and Points of Consideration

The Importance of Data in an Exclusive Human Milk Diet: Key Concepts and Points of Consideration

Human Immunodeficiency Virus and Breastfeeding

Association between social psychological status and efavirenz and nevirapine plasma concentration among HIV patients in Kenya

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