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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Population attributable fractions for late postnatal mother-to-child transmission of HIV-1 in sub-Saharan Africa
Journal of Acquired Immune Deficiency Syndromes, Volume 54, No. 3, Year 2010
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Description
Objectives: Assess population attributable fractions (PAFs) for late postnatal transmission (LPT) of HIV-1 in a cohort of HIV-1-exposed infants. Methods: We used data established from a risk factor analysis of LPT (negative HIV-1 results through the 4-6 week visit, but positive assays thereafter through the 12-month visit) from a perinatal clinical trial conducted in 3 sub-Saharan countries. PAFs were calculated as the proportions of excess LPTs attributed to identified risk factors. Results: For the cohort of 1317 infants, 206 (15.6%) had only low maternal CD4 counts (<200 cells/mm), 332 (25.2%) had only high maternal plasma viral loads (VLs) (>50,000 copies/mL), and 81 (6.2%) had both low CD4 counts and high VLs. Their PAFs were 26.0% [95% confidence interval (CI): 12.0% to 36.0%], 37.0% (95% CI: 22.0% to 51.0%), and 16.0% (95% CI: 6.0% to 25.0%), respectively. Conclusions: Our PAF analysis illustrates the public health impact of the substantial proportion of LPTs accounted for by high-risk women with both low CD4 counts and high VLs. In light of these results, access to and use of antiretroviral therapy by high-risk HIV-1-infected pregnant women is essential. Additional strategies to reduce LPT for those not meeting criteria for antiretroviral therapy should be implemented. Copyright © 2010 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Chen, Yingqing
United States, Seattle
Fred Hutchinson Cancer Research Center
Young, Alicia M.
United States, Seattle
Fred Hutchinson Cancer Research Center
Brown, Elizabeth R.
United States, Seattle
Fred Hutchinson Cancer Research Center
United States, Seattle
University of Washington
Chasela, Charles S.
Malawi, Lilongwe
Unc Project-malawi
Fiscus, Susan A.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Hoffman, Irving F.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Valentine, Megan E.
United States, Durham
Science Facilitation Department
Emel, Lynda Marie
United States, Seattle
Fred Hutchinson Cancer Research Center
Taha, Taha E.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Goldenberg, Robert L.
United States, Philadelphia
Drexel University College of Medicine
Read, Jennifer Suzanne
United States, Bethesda
National Institute of Child Health and Human Development Nichd
Statistics
Citations: 16
Authors: 11
Affiliations: 8
Identifiers
Doi:
10.1097/QAI.0b013e3181d61c2e
ISSN:
15254135
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Participants Gender
Female