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Mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) and its determinants: a cohort study in Kigali, Rwanda.

Abstract：

:The authors report the results of the first 2 years of follow-up of a prospective cohort study on the mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) and its determinants which started in November 1988 in Kigali, Rwanda. The study sample consists of 218 newborns of 215 HIV-1 seropositive women matched to 218 newborns of 216 HIV-1 seronegative women of the same age and parity. They were followed every 2 weeks during the first 2 years of follow-up. HIV-1 antibodies were detected by enzyme-linked immunoadsorbent assay and Western blot at 3-month intervals. Two methods of calculating the mother-to-child transmission rate were used: method 1 combines the information provided by the persistence of HIV-1 antibodies at 15 months of age in children born to HIV seropositive mothers and the excess mortality in this group compared with the cohort of children born to HIV seronegative mothers; method 2 is a case-by-case evaluation of all the children born to HIV seropositive mothers. A logistic regression model was used to study the determinants of transmission. The probability of survival at 24 months of age was 81% (95% confidence interval (CI) 75-86) in children born to seropositive mothers, compared with 95% (95% CI 92-98) in children born to seronegative mothers (p < 0.001). The mother-to-child transmission rate calculated with method 1 was 25.7% (95% CI 18.8-32.5). With method 2, the medium estimate was 24.7%. In the multivariate analysis, a CD4/CD8 ratio < 0.5 was the only maternal factor statistically associated with an increased risk of mother-to-child transmission of HIV-1 (odds ratio = 2.9, 95% CI 1.2-7.2). The authors' findings present evidence for a higher mother-to-child transmission rate of HIV-1 in children born in Rwanda than in industrialized countries.

journal_name

Am J Epidemiol

journal_title

American journal of epidemiology

authors

Lepage P,Van de Perre P,Msellati P,Hitimana DG,Simonon A,Van Goethem C,Mukamabano B,Karita E,Stevens AM,Mathieu G

doi

10.1093/oxfordjournals.aje.a116716

keywords:

["Africa","Africa South Of The Sahara","Age Factors","Antibodies--analysis","Biology","Breast Feeding","Child Mortality","Cohort Analysis","Demographic Factors","Developing Countries","Diseases","Eastern Africa","Examinations And Diagnoses","Family And Household","Family Characteristics","Family Relationships","French Speaking Africa","Health","Hiv Infections--transmission","Hiv Infections--women","Immunity","Immunologic Factors","Infant","Infant Mortality","Infant Nutrition","Laboratory Examinations And Diagnoses","Laboratory Procedures","Maternal-fetal Exchange","Mortality","Mothers","Nutrition","Parents","Physiology","Population","Population Characteristics","Population Dynamics","Pregnancy","Prospective Studies","Reproduction","Research Methodology","Risk Factors","Rwanda","Studies","Viral Diseases","Youth"]

subject

Has Abstract,Author List Incomplete

pub_date

1993-03-15 00:00:00

pages

589-99

issue

eissn

0002-9262

issn

1476-6256

journal_volume

137

pub_type

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Mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) and its determinants: a cohort study in Kigali, Rwanda.