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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Maternal HLA homozygosity and mother-child HLA concordance increase the risk of vertical transmission of HIV-1
Journal of Infectious Diseases, Volume 197, No. 8, Year 2008
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Description
Background. Mother-child human leukocyte antigen (HLA) concordance and maternal HLA homozygosity may increase the risk of vertical transmission of human immunodeficiency virus type 1 (HIV-1) risk by reducing infant immune responses. Methods. We analyzed mother-child HLA concordance and maternal HLA homozygosity in a Kenyan perinatal cohort receiving antenatal zidovudine. HLA concordance was scored as the number of shared class I alleles, and relative risk estimates were adjusted for maternal HIV-1 load. Results. Among 277 mother-infant pairs, HIV-1 transmission occurred in 58 infants (21%), with in utero transmission in 21 (36%), peripartum transmission in 26 (45%), and transmission via breast-feeding in 11 (19%). With increased concordance, we observed a significant increase in the risk of transmission overall (adjusted hazard ratio [aHR], 1.3 [95% confidence interval {CI}, 1.0-1.7]; P = .04), in utero (adjusted odds ratio, 1.72 [95% CI, 1.0-1.7]; P = .04), and via breast-feeding (aHR, 1.6 [95% CI, 1.0-2.5]; P = .04). Women with homozygosity had higher plasma HIV-1 RNA levels at 32 weeks of gestation (5.1 vs. 4.8 log10 copies/mL; P = .03) and an increased risk of transmission overall (aHR, 1.7 [95% CI, 1.1-2.7]; P = .03) and via breast-feeding (aHR, 5.8 [95% CI, 1.9-17.7]; P = .002). Conclusion. The risks of overall, in utero, and breast milk HIV-1 transmission increased with HLA concordance and homozygosity. The increased risk may be due to reduced alloimmunity or less diverse protective immune responses. © 2008 by the Infectious Diseases Society of America. All rights reserved.
Authors & Co-Authors
MacKelprang, Romel D.
United States, Seattle
University of Washington
John-Stewart, Grace C.
United States, Seattle
University of Washington
Carrington, Mary N.
United States, Frederick
Saic-frederick
Richardson, Barbra Ann
United States, Seattle
University of Washington
Rowland-Jones, Sarah Louise
United Kingdom, Oxford
Mrc Weatherall Institute of Molecular Medicine
Gao, Xiaojiang
United States, Frederick
Saic-frederick
Mbori-Ngacha, Dorothy A.
Kenya, Nairobi
University of Nairobi
Mabuka, Jennifer M.
Kenya, Nairobi
University of Nairobi
Lohman-Payne, Barbara L.
United States, Seattle
University of Washington
Kenya, Nairobi
University of Nairobi
Farquhar, Carey
United States, Seattle
University of Washington
Statistics
Citations: 72
Authors: 10
Affiliations: 4
Identifiers
Doi:
10.1086/529528
ISSN:
00221899
Research Areas
Environmental
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Case-Control Study
Participants Gender
Female