A. Aka-dago and . Sihé, Social sciences team Annabel Desgrées-du-Loû, Annick Tijou-Traoré, Benjamin Zanou Scientific Committee: Stéphane Blanche Composition of the Vertical Transmission Study Group. Study investigators

J. Darbyshire, Victoria Sithole (Community Advisory Board) and the study investigators. Data monitoring and Safety Committee: Cathy Wilfert (chair, Elizabeth Glaser Pediatric AIDS foundation), Carl Lombard (statistician, Medical Research Council, South Africa) Francis Crawley (Good Clinical Practice Alliance) Data management: Cookie Govender, Londiwe Mthethwa and team. Clinical team: Thembi Blose, Nqobile Mkhwanazi, Dumo Mkwanazi and team. Field team: Zanele Fakude, Samukelisiwe Dube and team. Laboratory team, Nono Simelela

J. Bryce, C. Boschi-pinto, K. Shibuya, and R. Black, WHO estimates of the causes of death in children, The Lancet, vol.365, issue.9465, pp.1147-1152, 2005.
DOI : 10.1016/S0140-6736(05)71877-8

V. Leroy, C. Sakarovitch, M. Cortina-borja, J. Mcintyre, and H. Coovadia, Is there a difference in the efficacy of peripartum antiretroviral regimens in reducing mother-to-child transmission of HIV in Africa?, AIDS, vol.19, issue.16, pp.1865-1875, 2005.
DOI : 10.1097/01.aids.0000188423.02786.55

H. Breastfeeding, Late postnatal transmission of HIV-1 in breast-fed children: an individual patient data meta-analysis, International Transmission Study Group (BHITS) J Infect Dis, vol.189, pp.2154-2166, 2004.

R. Becquet and M. Newell, Prevention of postnatal HIV infection: infant feeding and antiretroviral interventions, Current Opinion in HIV and AIDS, vol.2, issue.5, pp.361-366, 2007.
DOI : 10.1097/COH.0b013e3282cecef4

URL : https://hal.archives-ouvertes.fr/inserm-00168585

H. Coovadia, N. Rollins, R. Bland, K. Little, and A. Coutsoudis, Mother-to-child transmission of HIV-1 infection during exclusive breastfeeding: the first six months of life, Lancet, vol.369, pp.1607-1616, 2007.

A. Coutsoudis, K. Pillay, E. Spooner, L. Kuhn, and H. Coovadia, Influence of Infant Feeding Patterns on Early Mother-to-Child Transmission of HIV-1 in Durban, South Africa, Annals of the New York Academy of Sciences, vol.353, issue.1, pp.471-476, 1999.
DOI : 10.1111/j.1749-6632.2000.tb05482.x

P. Iliff, E. Piwoz, N. Tavengwa, C. Zunguza, and E. Marinda, Early exclusive breastfeeding reduces the risk of postnatal HIV-1 transmission and increases HIV-free survival, AIDS, vol.19, issue.7, pp.699-708, 2005.
DOI : 10.1097/01.aids.0000166093.16446.c9

V. Leroy, J. Karon, A. Alioum, E. Ekpini, and P. Van-de-perre, Postnatal transmission of HIV-1 after a maternal short-course zidovudine peripartum regimen in West Africa, AIDS, vol.17, issue.10, pp.1493-1501, 2003.
DOI : 10.1097/00002030-200307040-00010

T. Taha, D. Hoover, N. Kumwenda, S. Fiscus, and G. Kafulafula, Late Postnatal Transmission of HIV???1 and Associated Factors, The Journal of Infectious Diseases, vol.196, issue.1, pp.10-14, 2007.
DOI : 10.1086/518511

R. Becquet, D. Ekouevi, I. Viho, C. Sakarovitch, and H. Toure, Acceptability of Exclusive Breast-Feeding With Early Cessation to Prevent HIV Transmission Through Breast Milk, ANRS 1201/1202 Ditrame Plus, Abidjan, C??te d??Ivoire, ANRS 1201/1202 Ditrame Plus, pp.600-608, 2005.
DOI : 10.1097/01.qai.0000171726.17436.82

R. Becquet, L. Bequet, D. Ekouevi, I. Viho, and C. Sakarovitch, Two-Year Morbidity???Mortality and Alternatives to Prolonged Breast-Feeding among Children Born to HIV-Infected Mothers in C??te d'Ivoire, PLoS Medicine, vol.296, issue.1, p.17, 2007.
DOI : 10.1371/journal.pmed.0040017.sd001

F. Dabis, L. Bequet, D. Ekouevi, I. Viho, and F. Rouet, Field efficacy of Zidovudine, Lamivudine and single-dose Nevirapine to prevent peripartum transmission of HIV. The ANRS 1201/1202 Ditrame Plus study, AIDS, vol.19, pp.309-318, 2005.
URL : https://hal.archives-ouvertes.fr/inserm-00193079

N. Rollins, H. Coovadia, R. Bland, A. Coutsoudis, and M. Bennish, Pregnancy Outcomes in HIV-Infected and Uninfected Women in Rural and Urban South Africa, JAIDS Journal of Acquired Immune Deficiency Syndromes, vol.44, issue.3, pp.321-328, 2007.
DOI : 10.1097/QAI.0b013e31802ea4b0

M. Blettner, W. Sauerbrei, B. Schlehofer, T. Scheuchenpflug, and C. Friedenreich, Traditional reviews, meta-analyses and pooled analyses in epidemiology, International Journal of Epidemiology, vol.28, issue.1, pp.1-9, 1999.
DOI : 10.1093/ije/28.1.1

R. Bland, N. Rollins, H. Coovadia, A. Coutsoudis, and M. Newell, Infant feeding counselling for HIV-infected and uninfected women: appropriateness of choice and practice, Bulletin of the World Health Organization, vol.85, issue.4, pp.289-296, 2007.
DOI : 10.2471/BLT.06.032441

V. Leroy, C. Sakarovitch, I. Viho, R. Becquet, and D. Ekouevi, Acceptability of Formula-Feeding to Prevent HIV Postnatal Transmission, Abidjan, C??te d??Ivoire, JAIDS Journal of Acquired Immune Deficiency Syndromes, vol.44, issue.1, pp.77-86, 2007.
DOI : 10.1097/01.qai.0000243115.37035.97

R. Bland, N. Rollins, G. Solarsh, J. Van-den-broeck, and H. Coovadia, Maternal recall of exclusive breast feeding duration, Archives of Disease in Childhood, vol.88, issue.9, pp.778-783, 2003.
DOI : 10.1136/adc.88.9.778

P. Gaillard, E. Piwoz, and T. Farley, Collection of standardized information on infant feeding in the context of mother-to-child transmission of HIV, Statistics in Medicine, vol.70, issue.23, pp.3525-3537, 2001.
DOI : 10.1002/sim.1092

U. Who, Breastfeeding counselling, a training course: world Health Organization & United Nations Children's Fund, 1993.

F. Rouet, C. Montcho, C. Rouzioux, V. Leroy, and P. Msellati, Early diagnosis of paediatric HIV-1 infection among African breast-fed children using a quantitative plasma HIV RNA assay, AIDS, vol.15, issue.14, pp.1849-1856, 2001.
DOI : 10.1097/00002030-200109280-00015

F. Rouet, D. Ekouevi, M. Chaix, M. Burgard, and A. Inwoley, Transfer and Evaluation of an Automated, Low-Cost Real-Time Reverse Transcription-PCR Test for Diagnosis and Monitoring of Human Immunodeficiency Virus Type 1 Infection in a West African Resource-Limited Setting, Journal of Clinical Microbiology, vol.43, issue.6, pp.2709-2717, 2005.
DOI : 10.1128/JCM.43.6.2709-2717.2005

S. Cassol, M. Gill, R. Pilon, M. Cormier, and R. Voigt, Quantification of human immunodeficiency virus type 1 RNA from dried plasma spots collected on filter paper, J Clin Microbiol, vol.35, pp.2795-2801, 1997.

A. Alioum, F. Dabis, L. Dequae-merchadou, G. Haverkamp, and M. Hudgens, Estimating the efficacy of interventions to prevent mother-to-child transmission of HIV in breast-feeding populations: development of a consensus methodology, Statistics in Medicine, vol.53, issue.23, pp.3539-3556, 2001.
DOI : 10.1002/sim.1076

A. Alioum, M. Cortina-borja, F. Dabis, L. Dequae-merchadou, and G. Haverkamp, Estimating the Efficacy of Interventions to Prevent Mother-to-Child Transmission of Human Immunodeficiency Virus in Breastfeeding Populations: Comparing Statistical Methods, American Journal of Epidemiology, vol.158, issue.6, pp.596-605, 2003.
DOI : 10.1093/aje/kwg188

URL : https://hal.archives-ouvertes.fr/inserm-00263550

D. Cox and D. Oakes, Analysis of survival data, 1984.

E. Kaplan and P. Meier, Nonparametric Estimation from Incomplete Observations, Journal of the American Statistical Association, vol.37, issue.282, pp.457-481, 1958.
DOI : 10.1214/aoms/1177731566

P. Joly, L. Letenneur, A. Alioum, and D. Commenges, PHMPL: a computer program for hazard estimation using a penalized likelihood method with interval-censored and left-truncated data, Computer Methods and Programs in Biomedicine, vol.60, issue.3, pp.225-231, 1999.
DOI : 10.1016/S0169-2607(99)00018-8

URL : https://hal.archives-ouvertes.fr/inserm-00182450

M. Magoni, L. Bassani, P. Okong, P. Kituuka, and E. Germinario, Mode of infant feeding and HIV infection in children in a program for prevention of mother-to-child transmission in Uganda, AIDS, vol.19, issue.4, pp.433-437, 2005.
DOI : 10.1097/01.aids.0000161773.29029.c0

R. Nduati, G. John, D. Mbori-ngacha, B. Richardson, and J. Overbaugh, Effect of Breastfeeding and Formula Feeding on Transmission of HIV-1, JAMA, vol.283, issue.9, pp.1167-1174, 2000.
DOI : 10.1001/jama.283.9.1167

M. Colvin, M. Chopra, T. Doherty, D. Jackson, and J. Levin, Operational effectiveness of single-dose nevirapine in preventing mother-to-child transmission of HIV, Bulletin of the World Health Organization, vol.85, issue.6, pp.466-473, 2007.
DOI : 10.2471/BLT.06.033639

L. Guay, P. Musoke, T. Fleming, D. Bagenda, and M. Allen, Intrapartum and neonatal single-dose nevirapine compared with zidovudine for prevention of mother-to-child transmission of HIV-1 in Kampala, Uganda: HIVNET 012 randomised trial, The Lancet, vol.354, issue.9185, pp.795-802, 1999.
DOI : 10.1016/S0140-6736(99)07419-X

A. Coutsoudis, K. Pillay, L. Kuhn, E. Spooner, and W. Tsai, Method of feeding and transmission of HIV-1 from mothers to children by 15 months of age: prospective cohort study from Durban, South Africa, AIDS, vol.15, issue.3, pp.379-387, 2001.
DOI : 10.1097/00002030-200102160-00011

R. Bahl, C. Frost, B. Kirkwood, K. Edmond, and J. Martines, Infant feeding patterns and risks of death and hospitalization in the first half of infancy: multicentre cohort study, Bull World Health Organ, vol.83, pp.418-426, 2005.

K. Edmond, C. Zandoh, M. Quigley, S. Amenga-etego, and S. Owusu-agyei, Delayed Breastfeeding Initiation Increases Risk of Neonatal Mortality, PEDIATRICS, vol.117, issue.3, pp.380-386, 2006.
DOI : 10.1542/peds.2005-1496

R. Bland, R. Becquet, N. Rollins, A. Coutsoudis, and H. Coovadia, Breast Health Problems Are Rare in Both HIV-Infected and HIV-Uninfected Women Who Receive Counseling and Support for Breast-Feeding in South Africa, Clinical Infectious Diseases, vol.45, issue.11, pp.1502-1510, 2007.
DOI : 10.1086/523320

URL : https://hal.archives-ouvertes.fr/inserm-00171008

W. Oddy, The impact of breastmilk on infant and child health, Breastfeed Rev, vol.10, pp.5-18, 2002.

B. Popkin, L. Adair, J. Akin, R. Black, and J. Briscoe, Breast-feeding and diarrheal morbidity, Pediatrics, vol.86, pp.874-882, 1990.

R. Bland, N. Rollins, A. Coutsoudis, and H. Coovadia, Breastfeeding practices in an area of high HIV prevalence in rural South Africa, Acta Paediatrica, vol.285, issue.6, pp.704-711, 2002.
DOI : 10.1111/j.1651-2227.2002.tb03306.x

G. Poggensee, K. Schulze, I. Moneta, P. Mbezi, and C. Baryomunsi, Infant feeding practices in western Tanzania and Uganda: implications for infant feeding recommendations for HIV-infected mothers, Tropical Medicine and International Health, vol.58, issue.4, pp.477-485, 2004.
DOI : 10.1001/jama.283.9.1167

R. Bland, K. Little, H. Coovadia, A. Coutsoudis, and N. Rollins, Intervention to promote exclusive breast-feeding for the first 6 months of life in a high HIV prevalence area, AIDS, vol.22, issue.7, pp.883-891, 2008.
DOI : 10.1097/QAD.0b013e3282f768de

S. Coutinho, P. De-lira, M. De-carvalho-lima, and A. Ashworth, Comparison of the effect of two systems for the promotion of exclusive breastfeeding, The Lancet, vol.366, issue.9491, pp.1094-1100, 2005.
DOI : 10.1016/S0140-6736(05)67421-1

R. Becquet, V. Leroy, D. Ekouevi, I. Viho, and K. Castetbon, Complementary feeding adequacy in relation to nutritional status among early weaned breastfed children who are born to HIV-infected mothers: ANRS 1201, Ditrame Plus Pediatrics, vol.117, pp.701-710, 1202.
URL : https://hal.archives-ouvertes.fr/inserm-00189790

T. Creek, W. Arvelo, A. Kim, L. Lu, and A. Bowen, A Large Outbreak of Diarrhea among Non-breastfed Children in Botswana, 2006?Implications for HIV Prevention Strategies and Child Health, The 14th Conference on Retroviruses and Opportunistic Infections, 2007.

W. Johnson, C. Alons, L. Fidalgo, E. Piwoz, and S. Kahn, The challenge of providing adequate infant nutrition following early breastfeeding cessation by HIV-positive, food-insecure Mozambican mothers, 2006.

I. Thior, S. Lockman, L. Smeaton, R. Shapiro, and C. Wester, Breastfeeding Plus Infant Zidovudine Prophylaxis for 6 Months vs Formula Feeding Plus Infant Zidovudine for 1 Month to Reduce Mother-to-Child HIV Transmission in Botswana, JAMA, vol.296, issue.7, pp.794-805, 2006.
DOI : 10.1001/jama.296.7.794

T. Thomas, R. Masaba, A. Van-eijk, R. Ndivo, and P. Nasokho, Rates of diarrhea associated with early weaning among infants in Kisumu, Kenya; The 14th Conference on Retroviruses and Opportunistic Infections, 2007.

L. Kuhn, G. Aldrovandi, M. Sinkala, C. Kankasa, and K. Semrau, Effects of Early, Abrupt Weaning on HIV-free Survival of Children in Zambia, New England Journal of Medicine, vol.359, issue.2, 2008.
DOI : 10.1056/NEJMoa073788

B. Tonwe-gold, D. Ekouevi, I. Viho, C. Amani-bosse, and S. Toure, Antiretroviral Treatment and Prevention of Peripartum and Postnatal HIV Transmission in West Africa: Evaluation of a Two-Tiered Approach, PLoS Medicine, vol.346, issue.8, p.257, 2007.
DOI : 10.1371/journal.pmed.0040257.sd005

URL : https://hal.archives-ouvertes.fr/inserm-00170648

T. Thomas, R. Masaba, R. Ndivo, C. Zeh, and C. Borkowf, Prevention of Mother-to-Child Transmission of HIV-1 among Breastfeeding Mothers Using HAART: The Kisumu Breastfeeding Study, The 15th Conference on Retroviruses and Opportunistic Infections, 2003.

K. Israel-ballard, R. Donovan, C. Chantry, A. Coutsoudis, and H. Sheppard, Flash-Heat Inactivation of HIV-1 in Human Milk, JAIDS Journal of Acquired Immune Deficiency Syndromes, vol.PAP, pp.318-323, 2007.
DOI : 10.1097/QAI.0b013e318074eeca

B. Jeffery and K. Mercer, Pretoria pasteurisation: a potential method for the reduction of postnatal mother to child transmission of the human immunodeficiency virus, Journal of Tropical Pediatrics, vol.46, issue.4, pp.219-223, 2000.
DOI : 10.1093/tropej/46.4.219

L. Mofenson and J. Mcintyre, Advances and research directions in the prevention of mother-to-child HIV-1 transmission, The Lancet, vol.355, issue.9222, pp.2237-2244, 2000.
DOI : 10.1016/S0140-6736(00)02415-6

R. Becquet, Antiretroviral therapy among HIV-infected breastfeeding mothers: a promising strategy to prevent HIV postnatal transmission in Africa, Future HIV Therapy, vol.1, issue.1, pp.17-21, 2007.
DOI : 10.2217/17469600.1.1.17

K. Luzuriaga, M. Newell, F. Dabis, J. Excler, and J. Sullivan, Vaccines to prevent transmission of HIV-1 via breastmilk: scientific and logistical priorities, The Lancet, vol.368, issue.9534, pp.511-521, 2006.
DOI : 10.1016/S0140-6736(06)69159-9

C. Cames, C. Mouquet, K. Ayassou, O. Ky-zerbo, and B. Bazin, A sustainable baby food support for HIV-1-infected mothers. The Kesho Bora study initiative in Bobo Dioulasso, Burkina Faso. The XVI International AIDS conference, 2006.

N. Kumwenda, D. Hoover, L. Mofenson, M. Thigpen, and G. Kafulafula, Extended Antiretroviral Prophylaxis to Reduce Breast-Milk HIV-1 Transmission, New England Journal of Medicine, vol.359, issue.2, pp.119-129, 2008.
DOI : 10.1056/NEJMoa0801941