Perinatal transmission of human immunodeficiency virus type 1 by pregnant women with RNA virus loads <1000 copies/mL

Ioannidis, J.P.A. et al. (2001) Perinatal transmission of human immunodeficiency virus type 1 by pregnant women with RNA virus loads <1000 copies/mL. Journal of Infectious Diseases, 183(4), pp. 539-545. (doi:10.1086/318530)

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Abstract

In a collaboration of 7 European and United States prospective studies, 44 cases of vertical human immunodeficiency virus type 1 (HIV-1) transmission were identified among 1202 women with RNA virus loads <1000 copies/mL at delivery or at the measurement closest to delivery. For mothers receiving antiretroviral treatment during pregnancy or at the time of delivery (or both), there was a 1.0% transmission rate (8 of 834; 95% confidence interval [CI], 0.4%–1.9%), compared with 9.8% (36 of 368; 95% CI, 7.0%–13.4%) for untreated mothers (risk ratio, 0.10; 95% CI, 0.05–0.21). In multivariate analysis adjusting for study, transmission was lower with antiretroviral treatment (odds ratio [OR], 0.10; P < .001), cesarean section (OR, 0.30; P = .022), greater birth weight (P = .003), and higher CD4 cell count (P = .039). In 12 of 44 cases, multiple RNA measurements were obtained during pregnancy or at the time of delivery or within 4 months after giving birth; in 10 of the 12 cases, the geometric mean virus load was >500 copies/mL. Perinatal HIV-1 transmission occurs in only 1% of treated women with RNA virus loads <1000 copies/mL and may be almost eliminated with antiretroviral prophylaxis accompanied by suppression of maternal viremia.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Gray, Dr Linsay
Authors: Ioannidis, J.P.A., Abrams, E.J., Ammann, A., Bulterys, M., Goedert, J.J., Gray, L., Korber, B.T., Mayaux, M.J., Mofenson, L.M., Newell, M.‐L., Shapiro, D.E., Teglas, J.P., and Wilfert, C.M.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:Journal of Infectious Diseases
Publisher:Infectious Diseases Society of America
ISSN:0022-1899
ISSN (Online):1537-6613

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