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In utero and intra-partum HIV-1 transmission and acute HIV-1 infection during pregnancy: using the BED capture enzyme-immunoassay as a surrogate marker for acute infection.

Abstract：

OBJECTIVE:The BED assay was developed to estimate the proportion of recent HIV infections in a population. We used the BED assay as a proxy for acute infection to quantify the associated risk of mother-to-child-transmission (MTCT) during pregnancy and delivery. Design A total of 3773 HIV-1 sero-positive women were tested within 96 h of delivery using the BED assay, and CD4 cell count measurements were taken. Mothers were classified according to their likelihood of having recently seroconverted. METHODS:The risk of MTCT in utero and intra-partum was assessed comparing different groups defined by BED and CD4 cell count, adjusting for background factors using multinomial logistic models. RESULTS:Compared with women with BED ≥ 0.8/CD4 ≥ 350 (typical of HIV-1 chronic patients) there was insufficient evidence to conclude that women presenting with BED < 0.8/CD4 ≥ 350 (typical of recent infections) were more likely to transmit in utero [adjusted odds ratio (aOR) = 1.37, 96% confidence interval (CI) 0.90-2.08, P = 0.14], whereas women with BED < 0.8/CD4 200-349 (possibly recently infected patients) had a 2.57 (95% CI 1.39-4.77, P-value < 0.01) odds of transmitting in utero. Women who had BED < 0.8/CD4 < 200 were most likely to transmit in utero (aOR 3.73, 95% CI 1.27-10.96, P = 0.02). BED and CD4 cell count were not predictive of intra-partum infections. CONCLUSIONS:These data provide evidence that in utero transmission of HIV might be higher among women who seroconvert during pregnancy.

journal_name

Int J Epidemiol

journal_title

International journal of epidemiology

authors

Marinda ET,Moulton LH,Humphrey JH,Hargrove JW,Ntozini R,Mutasa K,Levin J

doi

10.1093/ije/dyr055

subject

Has Abstract

pub_date

2011-08-01 00:00:00

pages

945-54

issue

4

eissn

0300-5771

issn

1464-3685

pii

dyr055

journal_volume

40

pub_type

临床试验,杂志文章

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