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HIV-1 infection in a population-based twin sample
K Krasinski1, B J Turner, W W Hauck
1New York University Medical Center-Bellevue Hospital Center, New York, USA.
Pediatric AIDS and HIV Infection
|April 1, 1997
Summary
Advanced maternal HIV infection significantly increases perinatal HIV-1 transmission risk in twins. Reducing maternal viral load is key to preventing mother-to-child HIV transmission, more so than delivery factors like birth order.
Area of Science:
- Perinatology
- Infectious Diseases
- Epidemiology
Background:
- Perinatal human immunodeficiency virus type 1 (HIV-1) transmission remains a global health concern.
- Understanding transmission dynamics in twin gestations is crucial for targeted prevention strategies.
Purpose of the Study:
- To investigate factors influencing perinatal HIV-1 transmission specifically within twin births.
- To compare the impact of maternal disease stage and birth order on HIV-1 transmission in twins.
Main Methods:
- A population-based cohort of HIV-infected mothers and their twins was identified using New York State Medicaid data.
- Kaplan-Meier curves assessed transmission rates at 3 years post-delivery.
- Proportional hazards models, adjusted for twin clustering, determined relative hazards (RH) of transmission.
Main Results:
- The overall perinatal HIV-1 transmission rate in 35 twin pairs was 20.5%.
- Advanced maternal HIV-1 infection was a significant risk factor (RH=10.8, 95% CI: 2.11-54.9).
- No association was found between birth order and twin HIV-1 status.
Conclusions:
- Maternal disease stage is a more critical determinant of vertical HIV-1 transmission in twins than birth order.
- Strategies aimed at reducing maternal viral load are likely more effective in preventing mother-to-child HIV-1 transmission than focusing on delivery-related factors.