Abstract:
OBJECTIVE:To determine HIV-1 RNA load during the third trimester of pregnancy and evaluate its effect on in utero and intra-partum/postpartum transmissions in a breastfeeding population. DESIGN:A nested case-control study within a PMTCT cohort of antiretroviral therapy naive pregnant women and their infants. METHODS:A case was a mother who transmitted HIV-1 to her infant (transmitter) who was matched to one HIV-1 positive but non-transmitting mother (control). RESULTS:From a cohort of 691 pregnant women, 177 (25.6%) were HIV-1 positive at enrollment and from these 29 (23%) transmitted HIV-1 to their infants, 10 and 19 during in utero and intra-partum/postpartum respectively. Twenty-four mothers sero-converted after delivery and three transmitted HIV-1 to their infants. Each unit increase in log10 viral load was associated with a 178 cells/mm(3) and 0.2 g/dL decrease in TLC and hemoglobin levels, p = 0.048 and 0.021 respectively, and a 29% increase in the risk of transmission, p = 0.023. Intra-partum/postpartum transmitters had significantly higher mean viral load relative to their matched controls, p = 0.034. CONCLUSION:Antenatal serum HIV-1 RNA load, TLC and hemoglobin levels were significantly associated with vertical transmission but this association was independent of transmission time. This finding supports the rationale for preventive strategies designed to reduce vertical transmission by lowering maternal viral load.
journal_name
Virol Jjournal_title
Virology journalauthors
Duri K,Gumbo FZ,Kristiansen KI,Kurewa NE,Mapingure MP,Rusakaniko S,Chirenje MZ,Muller F,Stray-Pedersen Bdoi
10.1186/1743-422X-7-176subject
Has Abstractpub_date
2010-08-02 00:00:00pages
176issn
1743-422Xpii
1743-422X-7-176journal_volume
7pub_type
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