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Title: Maternal virus load and perinatal human immunodeficiency virus type 1 subtype E transmission, Thailand
Authors: Nathan Shaffer
Anuvat Roongpisuthipong
Wimol Siriwasin
Tawee Chotpitayasunondh
Sanay Chearskul
Nancy L. Young
Bharat Parekh
Philip A. Mock
Chaiporn Bhadrakom
Pratharn Chinayon
Marcia L. Kalish
Susan K. Phillips
Timothy C. Granade
Shambavi Subbarao
Bruce G. Weniger
Timothy D. Mastro
Mahidol University
Centers for Disease Control and Prevention
Keywords: Medicine
Issue Date: 1-Dec-1999
Citation: Journal of Infectious Diseases. Vol.179, No.3 (1999), 590-599
Abstract: To determine the rate and risk factors for human immunodeficiency virus (HIV)-1 subtype E perinatal transmission, with focus on virus load, pregnant HIV-infected women and their formula-fed infants were followed prospectively in Bangkok. Of 281 infants with known outcome, 68 were infected (transmission rate, 24.2%; 95% confidence interval, 19.3%-29.6%). Transmitting mothers had a 4.3-fold higher median plasma HIV RNA level at delivery than did nontransmitters (P < .001). No transmission occurred at <2000 copies/mL. On multivariate analysis, prematurity (adjusted odds ratio [AOR], 4.5), vaginal delivery (AOR, 2.9), low NK cell percentage (AOR, 2.4), and maternal virus load were associated with transmission. As RNA quintiles increased, the AOR for transmission increased linearly from 4.5 to 24.8. Two-thirds of transmission was attributed to virus load >10,000 copies/mL. Although risk is multifactorial, high maternal virus load at delivery strongly predicts transmission. This may have important implications for interventions designed to reduce perinatal transmission.
ISSN: 00221899
Appears in Collections:Scopus 1991-2000

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