Timing of mother-to-child transmission of HIV-1 and infant mortality in the first 6 months of life in Harare, Zimbabwe
| Autor: | Kuda Mutasa, Lucie C. Malaba, Parteson Zvandasara, Peter J. Iliff, Jean H. Humphrey, Lynn S. Zijenah, Brian J. Ward, Kusum Nathoo, Marshall Munjoma, Lawrence H. Moulton |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Zimbabwe medicine.medical_specialty Time Factors Birth weight Immunology Population HIV Infections Polymerase Chain Reaction Women in development Acquired immunodeficiency syndrome (AIDS) Pregnancy Risk Factors Infant Mortality medicine Humans Immunology and Allergy Childbirth Pregnancy Complications Infectious education education.field_of_study business.industry Obstetrics Infant Newborn Infant medicine.disease Survival Analysis Infectious Disease Transmission Vertical Infant mortality Confidence interval Surgery Survival Rate Infectious Diseases DNA Viral HIV-1 Female business |
| Zdroj: | AIDS. 18:273-280 |
| ISSN: | 0269-9370 |
| DOI: | 10.1097/00002030-200401230-00017 |
| Popis: | To examine the risks of intra-uterine (IU), intra- and early post-partum (IP/ePP) and late post-partum (LPP) mother-to-child transmission (MTCT) of HIV-1 and infant mortality in the first 6 months of life.Whole blood was collected in ethylenediaminetetra-acetic acid at birth, 6 weeks, 3 and 6 months from 996 infants born to HIV-1 seropositive mothers. Polymerase chain reaction using Roche DNA amplification assay, version 1.5 (Roche Diagnostics Incorporation, Alameda, California, USA) was used to determine timing of MTCT. Logistic regression models determined risk factors for HIV-1 transmission and survival analyses examined mortality by timing of transmission.Two hundred and forty-nine mothers (30.7%) transmitted HIV-1 infection to their infants by 6 months of age. Eighty-nine infants [9.4%; 95% confidence interval (CI), 7.7-11.5], 104 infants (16.0%; 95% CI, 10.8-21.2) and 21 infants (5.3%; 95% CI, 1.6-12.2) were infected IU, IP/ePP and LPP respectively. Low maternal CD4 cell count and arm circumference were risk factors for IP/ePP transmission. Infant mortality was higher among infected infants than uninfected (P0.001, log rank test). Timing of infection, birth weight and maternal CD4 cell counts were important factors in predicting infant death.In the first 6 months of life, IU and IP/ePP transmission contributed more than three-quarters of the 30.7% MTCT. Our data, in addition to serving as a historical comparison, may be useful in designing and evaluating the efficacy of short course antiretroviral trials aimed at reducing MTCT in developing countries. |
| Databáze: | OpenAIRE |
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