Document Detail

Twin pregnancy as a risk factor for mother-to-child transmission of HIV-1: trends over 20 years.
MedLine Citation:
PMID:  17457093     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We investigated whether twin pregnancies were at increased risk of mother-to-child HIV-1 transmission (MTCT), in comparison with singletons. METHODS: Among HIV-1 infected women enrolled in the French Perinatal HIV Cohort (n = 9262), we studied the association between twin deliveries and MTCT rate according to three time periods (pre-1994, 1994-1996, 1997-2004) and the effect of birth order. The mother was considered to have transmitted if at least one of the twins was infected. Univariate and multivariate analyses of risk factors for MTCT were performed for deliveries in the periods up to 1996. RESULTS: Overall, 2.1% (192/9262) of all the deliveries were twins. The rate of prematurity was greater in twins than in singletons (54% and 13%, respectively). Up to 1996 the rate of MTCT of HIV-1 was 28.3% (15/53) in twin pregnancies, versus 13.5% (414/3077) in singletons [odds ratio (OR), 2.5; 95% confidence interval (CI), 1.4-4.7; P = 0.002; adjusted OR, 2.3: 95% CI, 1.1-2.3; P = 0.03). In the period from 1997 to 2003, MTCT was low and did not differ between twins (1.0%) and singletons (1.8%; P = 1.0). Overall, the transmission rate for the first-born child was threefold that for the second-born child (14/164, 8.5% versus 4/164, 2.4%; P = 0.008). CONCLUSION: Twin pregnancies were at increased risk of transmission, but in the era of HAART this risk was reduced for twins, as well as singletons. Management of multiple pregnancies should take into account the risks of premature rupture of the membranes and preterm delivery.
Claudia Palladino Sili Scavalli; Laurent Mandelbrot; Alain Berrebi; Agnès Batallan; Ludovic Cravello; Emmanuelle Pannier; Karima Hamrene; Nicole Ciraru-Vigneron; Albert Faye; Josiane Warszawski;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  AIDS (London, England)     Volume:  21     ISSN:  0269-9370     ISO Abbreviation:  AIDS     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-25     Completed Date:  2007-07-03     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8710219     Medline TA:  AIDS     Country:  England    
Other Details:
Languages:  eng     Pagination:  993-1002     Citation Subset:  IM; X    
Inserm, U822, IFR69, Le Kremlin-Bicêtre, France.
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MeSH Terms
Anti-HIV Agents / therapeutic use
Birth Order
Diseases in Twins / epidemiology*
France / epidemiology
HIV Infections / drug therapy,  epidemiology,  transmission*,  virology
HIV-1* / isolation & purification
Infant, Newborn
Infant, Premature
Infectious Disease Transmission, Vertical*
Obstetric Labor, Premature
Pregnancy Complications, Infectious* / drug therapy,  virology
Pregnancy, Multiple
Prospective Studies
RNA, Viral / blood
Risk Factors
Reg. No./Substance:
0/Anti-HIV Agents; 0/RNA, Viral

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