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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
The effects of maternal helminth and malaria infections on mother-to-child HIV transmission
AIDS, Volume 19, No. 16, Year 2005
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Description
Objective: To investigate the effect of helminth and/or malaria infection on the risk of HIV infection in pregnant women and its transmission to their offspring. Design: A retrospective cohort study of pregnant Kenyan women and their offspring from term, uncomplicated vaginal deliveries (n = 936) with a nested case-control study. Methods: We determined the presence of HIV, malaria, schistosomiasis, lymphatic filariasis, and intestinal helminthes in mothers and tested for HIV antibodies in 12-24 month-old offspring of HIV-positive women. We related these findings to the presence of cord blood lymphocyte activation and cytokine production in response to helminth antigens. Results: HIV-positive women (n = 83, 8.9% of all women tested) were 2-fold more likely to have peripheral blood and/or placental malaria (P < 0.025) and a 2.1-fold greater likelihood of lymphatic filariasis infection (P < 0.001) compared to location-and-parity matched HIV-negative women. Women with HIV and malaria tended to show an increased risk for mother-to-child-transmission (MTCT) of HIV, although this difference was not significant. MTCT of HIV, however, was significantly higher in women co-infected with one or more helminthes (48%) verses women without helminth infections (10%, P < 0.01; adjusted odds ratio, 7.3; 95% confidence interval, 2.4-33.7). This increased risk for MTCT of HIV correlated with cord blood lymphocytes production of interleukin-5/interleukin- 13 in response to helminth antigens (P < 0.001). Conclusion: Helminth co-infection is associated with increased risk for MTCT of HIV, possibly by a mechanism in which parasite antigens activates lymphocytes in utero. Treatment of helminthic infections during pregnancy may reduce the risk of MTCT of HIV. © 2005 Lippincott Williams & Wilkins.
Authors & Co-Authors
Gallagher, Maureen
United States, Cleveland
Case School of Medicine
Malhotra, Indu J.
United States, Cleveland
Case School of Medicine
Mungai, Peter L.
United States, Cleveland
Case School of Medicine
Kenya, Nairobi
Division of Vector Borne Diseases
Wamachi, Alex N.
Kenya, Nairobi
Kenya Medical Research Institute
Kioko, John M.
Kenya, Nairobi
Division of Vector Borne Diseases
Ouma, John Henry
Kenya, Maseno
Maseno University
Muchiri, Eric M.
Kenya, Nairobi
Division of Vector Borne Diseases
King, Christopher L.
United States, Cleveland
Case School of Medicine
United States, Cleveland
Louis Stokes Cleveland va Medical Center
Statistics
Citations: 130
Authors: 8
Affiliations: 5
Identifiers
Doi:
10.1097/01.aids.0000189846.90946.5d
Research Areas
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cohort Study
Case-Control Study
Study Approach
Quantitative
Participants Gender
Female