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Clinical Trial
. 2015 Oct;42(10):554-65.
doi: 10.1097/OLQ.0000000000000340.

Chlamydia and Gonorrhea in HIV-Infected Pregnant Women and Infant HIV Transmission

Kristina Adachi  1 , Jeffrey D Klausner, Claire C Bristow, Jiahong Xu, Bonnie Ank, Mariza G Morgado, D Heather Watts, Fred Weir, David Persing, Lynne M Mofenson, Valdilea G Veloso, Jose Henrique Pilotto, Esau Joao, Karin Nielsen-Saines; NICHD HPTN 040 Study Team
Collaborators, Affiliations
Clinical Trial

Chlamydia and Gonorrhea in HIV-Infected Pregnant Women and Infant HIV Transmission

Kristina Adachi et al. Sex Transm Dis. 2015 Oct.

Abstract

Background: Sexually transmitted infections (STIs) such as Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) can lead to adverse pregnancy and neonatal outcomes. The prevalence of STIs and its association with HIV mother-to-child transmission (MTCT) were evaluated in a substudy analysis from a randomized, multicenter clinical trial.

Methodology: Urine samples from HIV-infected pregnant women collected at the time of labor and delivery were tested using polymerase chain reaction testing for the detection of CT and NG (Xpert CT/NG; Cepheid, Sunnyvale, CA). Infant HIV infection was determined by HIV DNA polymerase chain reaction at 3 months.

Results: Of the 1373 urine specimens, 249 (18.1%) were positive for CT and 63 (4.6%) for NG; 35 (2.5%) had both CT and NG detected. Among 117 cases of HIV MTCT (8.5% transmission), the lowest transmission rate occurred among infants born to CT- and NG-uninfected mothers (8.1%) as compared with those infected with only CT (10.7%) and both CT and NG (14.3%; P = 0.04). Infants born to CT-infected mothers had almost a 1.5-fold increased risk for HIV acquisition (odds ratio, 1.47; 95% confidence interval, 0.9-2.3; P = 0.09).

Conclusions: This cohort of HIV-infected pregnant women is at high risk for infection with CT and NG. Analysis suggests that STIs may predispose to an increased HIV MTCT risk in this high-risk cohort of HIV-infected women.

Trial registration: ClinicalTrials.gov NCT00099359.

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Conflict of interest statement

Disclosures and Conflict of Interest: None of the authors have any financial relationships or conflicts of interest to disclose except for the following: Fred Weir PhD is the Director of Research and Development at Cepheid. David Persing MD, PhD is the Executive Vice President, Chief Medical & Technology Officer of Cepheid.

Comment in

References

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    1. Organization WH. Global Strategy for Prevention and Control of Sexually Transmitted Infections: 2006–2105. Geneva, Switzerland: World Health Organization; 2006.

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