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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Timing of mother-to-child transmission of HIV-1 and infant mortality in the first 6 months of life in Harare, Zimbabwe
AIDS, Volume 18, No. 2, Year 2004
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Description
Objectives: To examine the risks of intra-uterine (IU), intra- and early post-partum (IP/ePP) and late post-partum (LPP) mother-to-child transmission (MTCT) of HIV-1 and infant mortality in the first 6 months of life. Methods: Whole blood was collected in ethylenediaminetetra-acetic acid at birth, 6 weeks, 3 and 6 months from 996 infants born to HIV-1 seropositive mothers. Polymerase chain reaction using Roche DNA amplification assay, version 1.5 (Roche Diagnostics Incorporation, Alameda, California, USA) was used to determine timing of MTCT. Logistic regression models determined risk factors for HIV-1 transmission and survival analyses examined mortality by timing of transmission. Results: Two hundred and forty-nine mothers (30.7%) transmitted HIV-1 infection to their infants by 6 months of age. Eighty-nine infants [9.4%; 95% confidence interval (CI), 7.7-11.5], 104 infants (16.0%; 95% CI, 10.8-21.2) and 21 infants (5.3%; 95% CI, 1.6-12.2) were infected IU, IP/ePP and LPP respectively. Low maternal CD4 cell count and arm circumference were risk factors for IP/ePP transmission. Infant mortality was higher among infected infants than uninfected (P < 0.001, log rank test). Timing of infection, birth weight and maternal CD4 cell counts were important factors in predicting infant death. Conclusion: In the first 6 months of life, IU and IP/ePP transmission contributed more than three-quarters of the 30.7% MTCT. Our data, in addition to serving as a historical comparison, may be useful in designing and evaluating the efficacy of short course antiretroviral trials aimed at reducing MTCT in developing countries. © 2004 Lippincott Williams & Wilkins.
Authors & Co-Authors
Zijenah, Lynn Sodai
Zimbabwe, Harare
University of Zimbabwe
Moulton, Lawrence H.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Iliff, Peter J.
Zimbabwe, Harare
University of Zimbabwe
Nathoo, Kusum Jackison
Zimbabwe, Harare
University of Zimbabwe
Munjoma, Marshall Wesley
Zimbabwe, Harare
University of Zimbabwe
Mutasa, Kuda E.
Zimbabwe, Harare
University of Zimbabwe
Malaba, Lucie C.
Zimbabwe, Harare
University of Zimbabwe
Zvandasara, Parteson
Zimbabwe, Harare
University of Zimbabwe
Ward, Brian James
Canada, Montreal
Université Mcgill
Humphrey, Jean H.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Zimbabwe, Harare
University of Zimbabwe
Statistics
Citations: 91
Authors: 10
Affiliations: 3
Identifiers
Doi:
10.1097/00002030-200401230-00017
Research Areas
Genetics And Genomics
Infectious Diseases
Maternal And Child Health
Study Locations
Zimbabwe