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Maternal viral load, CD4 cell count and vertical transmission of HIV‐1
Author(s) -
O'Shea Siobhan,
Newell MarieLouise,
Dunn David T.,
GarciaRodriguez MarieCruz,
Bates Isabel,
Mullen Jane,
Rostron Timothy,
Corbett Karen,
Aiyer Swati,
Butler Karina,
Smith Robert,
Banatvala Jangu E.
Publication year - 1998
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/(sici)1096-9071(199802)54:2<113::aid-jmv8>3.0.co;2-9
Subject(s) - viral load , transmission (telecommunications) , virology , pregnancy , virus , lentivirus , viral disease , gestation , biology , immunology , medicine , genetics , electrical engineering , engineering
Abstract HIV load and CD4 cell numbers were measured among 95 HIV infected women during pregnancy in order to determine their value as prognostic markers for transmission of virus from mother to infant. Among the 94 live births, 13 children were infected with HIV, 69 were uninfected and 12 were of unknown infection status. HIV RNA levels, as measured by nucleic acid sequence based amplification, were significantly higher ( P < 0.001) in women who transmitted virus than among those who did not transmit and maternal viral load was a stronger predictor of transmission than CD4 cell number. The predicted rate of transmission relative to maternal HIV RNA was 2% at 1,000 copies, 11% at 10,000 copies and 40% at 100,000 copies/ml. Little variation in viral load occurred during pregnancy and there was an association between viral load and prematurity, the mean gestation at delivery decreasing by 1.3 weeks for every 10‐fold increase in maternal HIV RNA ( P = 0.007). This study demonstrates that a high level of maternal HIV RNA is a risk factor for transmission of virus to the infant and maternal viral load is of more value as a prognostic marker for transmission risk than CD4 cell number. High viral load is also associated with premature delivery. Maternal viral load is therefore a useful marker on which to base management decisions during pregnancy. J. Med. Virol. 54:113–117, 1998. © 1998 Wiley‐Liss,Inc.