Document Detail


Maternal and perinatal factors related to maternal-infant transmission of HIV-1 in the P2C2 HIV study: the role of EBV shedding. Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted HIV-1 Infection (P2C2 HIV) Study Group.
MedLine Citation:
PMID:  9859959     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The association of maternal and perinatal factors with mother-infant transmission of HIV-1 was examined in a prospective multicenter cohort of singleton live births to 508 HIV-1-infected women with children of known HIV-1 infection status (91 [18%] HIV-1-infected, 417 [82%] uninfected). From multivariate logistic regression, independent predictors of HIV-1 transmission included maternal CD4 percentage (CD4%) (odds ratio [OR] per 10% increase in CD4% = 0.70; p = .003), ruptured membranes <24 hours (OR = 3.15; p = .02), and maternal bleeding (OR = 2.90; p = .03), whereas maternal zidovudine (ZDV) use was marginally associated (OR = 0.60; p = .08). The associations of maternal urinary cytomegalovirus (CMV) shedding, oropharyngeal Epstein-Barr virus (EBV) shedding, and serology profiles during pregnancy with HIV-1 transmission were examined in the subset of mothers in whom the CMV and EBV measurements were available. Maternal EBV seropositivity, CMV shedding, and CMV seropositivity were 100% (279 of 279), 7% (16 of 229), and 92% (270 of 274), respectively. These rates did not differ between transmitting and nontransmitting mothers. In univariate analyses, maternal EBV shedding was higher among transmitting than nontransmitting mothers (40 of 49 [82%] compared with 154 of 226 [68%]; p = .06) and was independently associated with transmission in multivariate logistic analyses adjusting for CD4%, ruptured membranes, and ZDV use, with an OR of 2.45 (95% confidence interval (CI), 1.03-5.84; p = .04). This permits the conclusion that EBV shedding is associated with maternal-infant HIV-1 transmission, independent of CD4%.
Authors:
J Pitt; M Schluchter; H Jenson; A Kovacs; P LaRussa; K McIntosh; P Boyer; E Cooper; J Goldfarb; H Hammill; D Hodes; H Peavy; R Sperling; R Tuomala; W Shearer
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association     Volume:  19     ISSN:  1077-9450     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr. Hum. Retrovirol.     Publication Date:  1998 Dec 
Date Detail:
Created Date:  1998-12-31     Completed Date:  1998-12-31     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9501482     Medline TA:  J Acquir Immune Defic Syndr Hum Retrovirol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  462-70     Citation Subset:  IM; X    
Affiliation:
Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.
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MeSH Terms
Descriptor/Qualifier:
Anti-HIV Agents / therapeutic use
CD4 Lymphocyte Count
CD4-CD8 Ratio
Cohort Studies
Cytomegalovirus / isolation & purification,  physiology
Female
Gestational Age
HIV Infections / complications,  transmission*,  virology
HIV-1*
Herpesviridae Infections / complications,  virology
Herpesvirus 4, Human / isolation & purification,  physiology*
Humans
Infant, Newborn
Infectious Disease Transmission, Vertical*
Male
Oropharynx / virology
Pregnancy
Pregnancy Complications, Infectious* / virology
Prospective Studies
Risk Factors
Urine / virology
Uterine Hemorrhage / complications
Virus Shedding*
Zidovudine / therapeutic use
Grant Support
ID/Acronym/Agency:
N01-HR-96037/HR/NHLBI NIH HHS; N01-HR-96038/HR/NHLBI NIH HHS; N01-HR-96039/HR/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 30516-87-1/Zidovudine

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