Combined evaluation of sexually transmitted infections in HIV-infected pregnant women and infant HIV transmission

Combined evaluation of sexually transmitted infections in HIV-infected pregnant women and infant HIV transmission

Author Adachi, Kristina Google Scholar
Xu, Jiahong Google Scholar
Yeganeh, Nava Google Scholar
Camarca, Margaret Google Scholar
Morgado, Mariza G. Google Scholar
Watts, D. Heather Google Scholar
Mofenson, Lynne M. Google Scholar
Veloso, Valdilea G. Google Scholar
Pilotto, Jose Henrique Google Scholar
Joao, Esau Google Scholar
Gray, Glenda Google Scholar
Theron, Gerhard Google Scholar
Santos, Breno Google Scholar
Fonseca, Rosana Google Scholar
Kreitchmann, Regis Google Scholar
Pinto, Jorge Google Scholar
Mussi-Pinhata, Marisa M. Google Scholar
Ceriotto, Mariana Google Scholar
Machado, Daisy Maria Autor UNIFESP Google Scholar
Bryson, Yvonne J. Google Scholar
Grinsztejn, Beatriz Google Scholar
Moye, Jack Google Scholar
Klausner, Jeffrey D. Google Scholar
Bristow, Claire C. Google Scholar
Dickover, Ruth Google Scholar
Mirochnick, Mark Google Scholar
Nielsen-Saines, Karin Google Scholar
Abstract Background Sexually transmitted infections (STIs) including Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Treponema pallidum (TP), and cytomegalovirus (CMV) may lead to adverse pregnancy and infant outcomes. The role of combined maternal STIs in HIV mother-to-child transmission (MTCT) was evaluated in mother-infant pairs from NICHD HPTN 040. Methodology Urine samples from HIV-infected pregnant women during labor were tested by polymerase chain reaction (PCR) for CT, NG, and CMV. Infant HIV infection was determined by serial HIV DNA PCR testing. Maternal syphilis was tested by VDRL and confirmatory treponemal antibodies. Results A total of 899 mother-infant pairs were evaluated. Over 30% had at least one of the following infections (TP, CT, NG, and/or CMV) detected at the time of delivery. High rates of TP (8.7%), CT (17.8%), NG (4%), and CMV (6.3%) were observed. HIV MTCT was 9.1% (n = 82 infants). HIV MTCT was 12.5%, 10.3%, 11.1%, and 26.3% among infants born to women with CT, TP, NG or CMV respectively. Forty-two percent of HIV-infected infants were born to women with at least one of these 4 infections. Women with these infections were nearly twice as likely to have an HIV-infected infant (aOR 1.9, 95% CI 1.1-3.0), particularly those with 2 STIs (aOR 3.4, 95% CI 1.5-7.7). Individually, maternal CMV (aOR 4.4 1.5-13.0) and infant congenital CMV (OR 4.1, 95% CI 2.2-7.8) but not other STIs (TP, CT, or NG) were associated with an increased risk of HIV MTCT. Conclusion HIV-infected pregnant women identified during labor are at high risk for STIs. Co-infection with STIs including CMV nearly doubles HIV MTCT risk. CMV infection appears to confer the largest risk of HIV MTCT.
xmlui.dri2xhtml.METS-1.0.item-coverage San Francisco
Language English
(Brazilian AIDS Prevention Trials International Network), NIAID/ NIH
National Institute of Allergy and Infectious Diseases (NIAID)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
National Institute of Mental Health (NIMH)
Boehringer Ingelheim Pharmaceuticals Inc. (BIPI)
GlaxoSmithKline, on behalf of ViiV Healthcare
Cepheid for the testing of CT
NG in a prior HPTN
UCLA Children's Discovery and Innovation Institute (CDI) through the Harry Winston Fellowship Award
UCLA AIDS Institute
UCLA Center for AIDS Research (CFAR) NIH/ NIAID
UCLA Pediatric AIDS Coalition, and Westat
Grant number NICHD (NICHD): HHSN267200800001C, N01-HD-8-0001
Brazilian AIDS Prevention Trials International Network: NIAID/ NIH [U01 AI047986
National Institute of Allergy and Infectious Diseases (NIAID): U01 AI068632, UM1AI068632, UM1AI068616, UM1AI106716
NIMH: AI068632
NG in a prior HPTN :040
UCLA Center for AIDS Research (CFAR) NIH/ NIAID: AI02869, AI28697
NIH/NICHD: HHSN275201300003C
Date 2018
Published in Plos One. San Francisco, v. 13, n. 1, p. -, 2018.
ISSN 1932-6203 (Sherpa/Romeo, impact factor)
Publisher Public Library Science
Extent -
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000419403800025

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