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Clinical Trial
. 2008 Mar;27(3):251-6.
doi: 10.1097/INF.0b013e31815b4960.

Risk factors for late postnatal transmission of human immunodeficiency virus type 1 in sub-Saharan Africa

Charles Chasela  1 , Ying Qing Chen, Susan Fiscus, Irving Hoffman, Alicia Young, Megan Valentine, Lynda Emel, Taha E Taha, Robert L Goldenberg, Jennifer S Read
Affiliations
Clinical Trial

Risk factors for late postnatal transmission of human immunodeficiency virus type 1 in sub-Saharan Africa

Charles Chasela et al. Pediatr Infect Dis J. 2008 Mar.

Abstract

Background: We conducted secondary data analyses of a clinical trial (HIVNET 024) to assess risk factors for late postnatal transmission (LPT) of human immunodeficiency virus type 1 (HIV-1) through breast-feeding.

Methods: Data regarding live born, singleton infants of HIV-1-infected mothers were analyzed. The timing of HIV-1 transmission through 12 months after birth was defined as: in utero (positive HIV-1 RNA results at birth), perinatal/early postnatal (negative results at birth, positive at 4-6 week visit), or LPT (negative results through the 4-6 week visit, but positive assays thereafter through the 12-month visit). HIV-1-uninfected infants were those with negative HIV-1 enzyme immunoassay results at 12 months of age, or infants with negative HIV-1 RNA results throughout follow-up.

Results: Of 2292 HIV-1-infected enrolled women, 2052 mother/infant pairs met inclusion criteria. Of 1979 infants with HIV-1 tests, 404 were HIV-1-infected, and 382 had known timing of infection (LPT represented 22% of transmissions). Further analyses of LPT included infants who were breast-feeding at the 4-6 week visit (with negative HIV-1 results at that visit) revealed 6.9% of 1317 infants acquired HIV-1 infection through LPT by 12 months of age. More advanced maternal HIV-1 disease at enrollment (lower CD4 counts, higher plasma viral loads) were the factors associated with LPT in adjusted analyses.

Conclusions: In this breast-feeding population, 6.9% of infants uninfected at 6 weeks of age acquired HIV-1 infection by 12 months. Making interventions to decrease the risk of LPT of HIV-1 available and continuing research regarding the mechanisms of LPT (so as to develop improved interventions to reduce such transmission) remain essential.

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Figures

Figure 1
Figure 1
Kaplan Meier curves depicting the proportion of infants who were breastfeeding at different time points during the first 12 months of life, according to clinical site.
See this image and copyright information in PMC

References

    1. Read JS. Prevention of mother-to-child transmission of HIV. In: Zeichner SL, Read JS, editors. Textbook of Pediatric HIV Care. Cambridge, England: Cambridge University Press; 2005. pp. 111–33.
    1. The Working Group on Mother-to-Child Transmission of HIV. Rates of mother-to-child transmission of HIV-1 in Africa, America, and Europe: results from 13 perinatal studies. J Acquir Immune Defic Syndr Hum Retrovirol. 1995;8(5):506–510. - PubMed
    1. The Breastfeeding and HIV International Transmission Study (BHITS) Group. Late postnatal transmission of HIV-1 in breastfed children: an individual patient data meta-analysis. J Infect Dis. 2004;189:2154–2166. - PubMed
    1. Taha T, Hoffman I, Fawzi W, Brown E, Read JS, Valentine M, et al. A phase III clinical trial of antibiotics to reduce chorioamnionitis-related perinatal HIV-1 transmission (HPTN024) AIDS. 2006;20:1313–1321. - PubMed
    1. Guay L, Musoke P, Fleming T, Bagenda D, Allen M, Nakabiito C, et al. Intrapartum and neonatal single-dose nevirapine compared with zidovudine for prevention of mother-to-child transmission of HIV-1 in Kampala, Uganda: HIVNET 012 randomised trial. Lancet. 1999;354(9181):795–802. - PubMed

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