Maternal predictors of perinatal human immunodeficiency virus transmission

Pauline A. Thomas, Jeremy Weedon, Keith Krasinski, Elaine Abrams, Nathan Shaffer, Pamela Matheson, Mahrukh Bamji, Aditya Kaul, David Hutson, Katherine T. Grimm, Sara T. Beatrice, Martha Rogers, Erica Debernardo, Keith Lawrence, William Oleszko, Amado Punsalang, Mary Ann Chiasson, Katharine McVeigh, Ana Vertus, Tina AlfordMark Cappelli, Nilda Carrasquillo, Renee Courtlandt, Nancy Cruz, Julia Floyd, Sylvia Hutchison, Lynn Jackson, Dora Lopez, Luis Macias, Debbie Ng, Jeanette Rios, Roxanne Savory, Hany Tadros, Brenda Williams, Sadarryle Young, Zhong Ren Zhang, Dorothy Jessop, Lucille Rosenbluth, Margaret Heagarty, Steve Nicholas, David Bateman, Janet Mitchell, Gina Brown, Maria Suarez, William Borkowsky, Henry Pollack, Machelle H. Allen, William Hoover, Mary Vogler, Danielle Milano, Jean Chow, Sharon Nachman, Kiran Shah, Eileen Sacharzky, Roger Henriquez, Elmer Agustin, S. Ahmed, Sylvia I. Losub, Richard Brotman, Stanley Blanch, Jesse Brutus, Carol Day, Wendy Rhine-Hart, Raymond Simon, Victor Turkell, Genevieve Lambert, Barbara Johnston, Laurie Soloman, Sarah Davilla, Delia Grant, Marilyn Neves, Charles Schable, Sandra Larsen, Otto Von Assendelft, Judy Petzalt, Jennifer Rapier, Chin Yih Ou, Barbara Kilbourne, Lisa Smith, Rita O’donnell, Lee Anderson, Laurie Beck, Nancy Briggs, Doris Casella, Terry Dugan, Marizette Ferreira, Juanita Lopez, Alourdez Monestine, Lesley Pratt, Martha Sanchez, Rudolph White

Research output: Contribution to journalArticlepeer-review

78 Scopus citations

Abstract

This analysis sought to identify characteristics of pregnant human immunodeficiency virus type 1 (HlV-l)-infected women that predict mother-to-child HIV-1 transmission. Pregnant and immediately postpartum women at risk for HIV were enrolled at obstetric and pediatric care settings in New York City from 1986 to 1992. Demographic and behavioral characteristics, clinical illness, T lymphocyte subsets, immunoglobulin concentration and syphilis serology were collected on the women. Infants were followed to determine HIV infection classification according to Centers for Disease Control and Prevention criteria for HIV-1 in children. Transmission rates were calculated for women who gave birth more than 15 months before the analysis. Of 172 HIV-1-infected women with known outcome 49 (28%) had infected infants. The transmission rate (TR) was significantly higher among women with <280 CD4+ cells/μl (lowest CD4+ quartile) than with CD4+ counts >280 (48% vs. 227c; P = 0.004; odds ratio, 3.4; 95% confidence interval (1.5, 7.8)); a similar trend was seen by CD4+% quartile. No difference in TR was seen comparing women by CD8+ count quartile but marginally higher TR was seen among women with CD8+% ≥51% than with CD8+% <51% (TR = 41% vs. 24%; P = 0.076; odds ratio, 2.2; confidence interval (1.0, 5.1)). The highest TR, 62%, was seen in women with both CD8+ count above the median and CD4+ count in the lowest quartile. No significant difference in TR was seen between women with and without HIV-related illness, although the TR was 53% among women hospitalized in the previous year for pneumonia compared with 25% in others (P = 0.03). TR was somewhat lower in women who delivered by cesarean section than vaginally (entire cohort: 18% vs. 32%, P = 0.11; prenatal enrollees only, 17% vs. 387c, P = 0.045). No factor or combination of factors was both highly sensitive and specific for predicting mother-to-child HIV transmission. A possible relationship between transmission and mode of delivery deserves further investigation.

Original languageEnglish
Pages (from-to)489-495
Number of pages7
JournalPediatric Infectious Disease
Volume13
Issue number6
DOIs
StatePublished - Jun 1994
Externally publishedYes

Keywords

  • Mother-to child human immunodeficiency virus transmission
  • Pediatric acquired immunodeficiency syndrome
  • Perinatal human immunodeficiency virus
  • Predictors of perinatal transmission

Fingerprint

Dive into the research topics of 'Maternal predictors of perinatal human immunodeficiency virus transmission'. Together they form a unique fingerprint.

Cite this