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Ex vivo Culture of Human Placental Explants for the Study of Viral Transmission Across the Maternal-Fetal Interface
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Risk factors for in utero and intrapartum transmission of HIV

Laurence S Magder1, Lynne Mofenson, Mary E Paul

  • 1Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore, MD, USA. Lmagder@epi.maryland.edu

Journal of Acquired Immune Deficiency Syndromes (1999)
|December 21, 2004
PubMed

Insights

Perinatal HIV-1 transmission significantly decreased between 1990-2000, but in utero transmission increased. Maternal viral load and antiretroviral therapy predict transmission risk in infants.

Area of Science:

  • Infectious Diseases
  • Virology
  • Pediatrics

Background:

  • Perinatal Human Immunodeficiency Virus type 1 (HIV-1) transmission remains a significant global health concern.
  • Understanding transmission dynamics is crucial for developing effective prevention strategies.

Purpose of the Study:

  • To identify predictors of in utero and intrapartum HIV-1 transmission in infants.
  • To analyze trends in perinatal HIV-1 infection over a decade.

Main Methods:

  • Retrospective analysis of data from the Women and Infants Transmission Study (1990-2000).
  • Defined in utero and intrapartum HIV-1 infection based on infant testing timing.
  • Statistical analysis to identify associated risk factors.

Main Results:

  • Overall perinatal HIV-1 transmission decreased from 18.1% to 1.6% during the study period.
  • The proportion of in utero transmissions among infected infants increased significantly over time.
  • Maternal antenatal viral load and antiretroviral therapy were key predictors for both transmission routes.

Conclusions:

  • Despite overall declines in perinatal HIV-1 infection, a shift towards in utero transmission has occurred.
  • Maternal factors like viral load and treatment are critical in preventing mother-to-child HIV-1 transmission.
Abstract

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