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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Maternal Herpes simplex virus type 2 infection, syphilis and risk of intra-partum transmission of HIV-1: Results of a case control study
AIDS, Volume 22, No. 2, Year 2008
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Description
BACKGROUND: Genital ulcer disease including that caused by Herpes simplex virus type 2 (HSV-2) and syphilis facilitates sexual transmission of HIV-1. The effect of these infections on intra-partum mother-to-child-transmission (MTCT) of HIV-1 is unknown. METHODS: A case-control study was conducted using archived sera from HIV-1 positive women enrolled in ZVITAMBO, an MTCT trial. Cases were 509 women who transmitted HIV-1 to their infants intra-partum; controls were 1018 women whose infants remained uninfected at 12 months. Maternal serum collected at delivery, were tested for HSV-2 antibody. The 6-week post-partum sample was also tested for syphilis by RPR and TPHA to identify women with incubating or active syphilis at delivery. Rates of prevalent and incident HSV-2 and recently acquired syphilis were compared between cases and controls. FINDINGS: Overall prevalence of maternal HSV-2 and active syphilis at delivery were 82.5% [95% confidence interval (CI), 80.6-84.5] and 4.0% (95% CI, 3.0-5.1), respectively. Prevalent HSV-2 was associated with increased intra-partum MTCT [adjusted odds ratio (OR), 1.50; 95% CI, 1.09-2.08]. The proportion of intra-partum transmissions potentially attributable to prevalent HSV-2 infection was 28.4% (95% CI, 7.3-44.7). Maternal infection with active syphilis at delivery was not associated with intra-partum MTCT (unadjusted OR, 0.89; 95%CI, 0.49-1.59; adjusted OR, 0.64; 95% CI, 0.34-1.20). INTERPRETATION: HSV-2 infection is common among HIV-1-positive women and is associated with an increased risk of intra-partum MTCT. More than 25% of intra-partum MTCT may be attributable to maternal HSV-2 co-infection. Active maternal syphilis at the time of delivery is not associated with intra-partum MTCT risk. © 2008 Lippincott Williams & Wilkins, Inc.
Authors & Co-Authors
Cowan, Frances Mary
United Kingdom, London
Ucl Medical School
Humphrey, Jean H.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Zimbabwe, Harare
Zvitambo Project
Zimbabwe, Harare
Zvitambo Study Team
Ntozini, Robert
Zimbabwe, Harare
Zvitambo Project
Mutasa, Kuda E.
Zimbabwe, Harare
Zvitambo Project
Ashley, Rhoda L.
United States, Seattle
Chrmc
Iliff, Peter J.
Zimbabwe, Harare
Zvitambo Project
Statistics
Citations: 74
Authors: 6
Affiliations: 5
Identifiers
Doi:
10.1097/QAD.0b013e3282f2a939
Research Areas
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Case-Control Study
Participants Gender
Female