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A prospective population-based study of HIV perinatal transmission
S R Nesheim1, M Lindsay, M K Sawyer
1Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia 30303.
AIDS (London, England)
|September 1, 1994
Summary
Perinatal HIV transmission occurred in 17% of infants born to HIV-positive mothers. Early mortality in infected infants was significant, highlighting the need for further research into transmission factors.
Area of Science:
- Infectious Diseases
- Pediatrics
- Epidemiology
Background:
- Routine voluntary HIV testing in pregnant women is crucial for identifying at-risk infants.
- Understanding perinatal HIV transmission is vital for developing effective prevention strategies.
- The natural history of infant HIV infection requires ongoing study.
Purpose of the Study:
- To determine the perinatal human immunodeficiency virus (HIV) transmission rate.
- To describe the natural history of HIV infection in infants born to HIV-positive mothers.
- To analyze factors influencing HIV transmission in a high-risk population.
Main Methods:
- A cohort study followed 165 HIV-exposed infants born between 1987 and 1990.
- Infant outcomes were assessed using clinical and laboratory measures.
- Maternal HIV status was identified through universal voluntary HIV testing.
Main Results:
- The overall perinatal HIV transmission rate was 17% (95% CI: 11-24%), declining to 11% by the third year.
- Gestational growth, prematurity, and delivery mode did not correlate with transmission.
- Intravenous drug use showed a trend towards higher transmission rates (P=0.08).
- Among infected infants, opportunistic infections (e.g., Pneumocystis carinii pneumonia) and mortality were significant, with 32% mortality by age 2.
Conclusions:
- Perinatal HIV transmission in this cohort was 17%.
- Further research is needed to understand factors influencing transmission rates and future trends.
- Early identification and monitoring of HIV-exposed infants are critical.