Distinct Risk Factors for Intrauterine and Intrapartum Human Immunodeficiency Virus Transmission and Consequences for Disease Progression in Infected Children | Zendy

Louise Kuhn | Zendy; Richard W. Steketee | Zendy; Jeremy Weedon | Zendy; Elaine J. Abrams | Zendy; Geneviève Lambert | Zendy; Marukh Bamji | Zendy; Ellie E. Schoenbaum | Zendy; John Farley | Zendy; Steve R. Nesheim | Zendy; Paul Palumbo | Zendy; R. J. Simonds | Zendy; Donald M. Thea | Zendy

Open Access

Distinct Risk Factors for Intrauterine and Intrapartum Human Immunodeficiency Virus Transmission and Consequences for Disease Progression in Infected Children

Author(s) -

Louise Kuhn,

Richard W. Steketee,

Jeremy Weedon,

Elaine J. Abrams,

Geneviève Lambert,

Marukh Bamji,

Ellie E. Schoenbaum,

John Farley,

Steve R. Nesheim,

Paul Palumbo,

R. J. Simonds,

Donald M. Thea

Publication year - 1999

Publication title -

the journal of infectious diseases

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 2.69

H-Index - 252

eISSN - 1537-6613

pISSN - 0022-1899

DOI - 10.1086/314551

Subject(s) - zidovudine , medicine , transmission (telecommunications) , obstetrics , pregnancy , relative risk , confidence interval , viral load , viral disease , immunology , pediatrics , human immunodeficiency virus (hiv) , biology , electrical engineering , genetics , engineering

Predictors and prognosis of intrauterine and intrapartum human immunodeficiency virus (HIV) transmission were investigated among 432 children of HIV-infected women in the Perinatal AIDS Collaborative Transmission Study. Timing of transmission was inferred from polymerase chain reaction or viral culture within 2 days of birth. Proportions of infections due to intrauterine transmission were similar among women using (29%) or not using zidovudine (30%). Preterm delivery was strongly associated with intrapartum transmission (relative risk, 3.7; 95% confidence interval [CI], 2.2-6.1), particularly among infants delivered longer after membrane rupture, but was not associated with intrauterine transmission. Progression to AIDS or death increased 2.5-fold (95% CI, 1.1-5.8) among intrauterine infected children, adjusting for preterm delivery, and maternal CD4 cell count. Early transmission appears unlikely to explain instances of zidovudine failure. Preterm infants may be more vulnerable to HIV acquisition at delivery, especially if membrane rupture is prolonged. Intrauterine infection does not appear to increase risk of preterm delivery.

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