Determinants of mother-to-child transmission of human immunodeficiency virus type 1 infection in a cohort from Durban, South Africa
- 1 July 1996
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in The Pediatric Infectious Disease Journal
- Vol. 15 (7), 604-610
- https://doi.org/10.1097/00006454-199607000-00009
Abstract
Objectives To determine the vertical transmission rate of HIV-1 infection and to assess the influence of maternal risk factors on transmission in infants born to HIV-1-infected black women in Durban. Design A prospective, hospital-based cohort study conducted at King Edward VIII hospital, Durban. HIV-1-seropositive women were enrolled into the study, and their infants were followed up at regular intervals from birth to early childhood. The infection status of the children was classified and the transmission rate was computed according to the recommendations of the workshop held in Ghent, Belgium (1992). Results The final cohort of 181 infants were classified as 48 infected, 93 not infected and 40 indeterminate. Clearance of maternal antibodies was achieved by 12 months of age in virtually all infants who became seronegative. The intermediate transmission rate was 34% (95% confidence interval, 26 to 42). Deliveries by cesarean section had significantly lower transmission (relative risk, 0.46; 95% confidence interval 0.23 to 0.91). Women with lower hemoglobin concentrations during pregnancy ( Conclusions This study, the first from South Africa, has confirmed that the rate of vertical transmission of HIV-1 is as high as that reported from most African cohorts. Cesarean sections were protective against transmission, whereas low hemoglobin values were associated with an increased risk of transmission. Twelve months could be used as the cutoff age for the diagnosis of vertical infection using antibody tests.Keywords
This publication has 28 references indexed in Scilit:
- Infant feeding policy and practice in the presence of HIV-1 infectionAIDS, 1995
- Caesarean section and vertical transmission of HIV-1The Lancet, 1994
- Factors predictive of maternal-fetal transmission of HIV-1. Preliminary analysis of zidovudine given during pregnancy and/or deliveryJAMA, 1994
- Seroprevalence of HIV infection in rural South AfricaAIDS, 1992
- RESUMPTION OF BREAST-FEEDING IN LATER CHILDHOODThe Pediatric Infectious Disease Journal, 1992
- HIV and child-bearingAIDS, 1991
- Evidence from Zaire that breast-feeding by HIV-1-seropositive mothers is not a major route for perinatal HIV-1 transmission but does decrease morbidityAIDS, 1991
- Perinatal transmission of HIV-I in Zambia.BMJ, 1989
- A Prospective Study of Infants Born to Women Seropositive for Human Immunodeficiency Virus Type 1New England Journal of Medicine, 1989
- Perinatal Transmission of the Human Immunodeficiency Virus Type 1 to Infants of Seropositive Women in ZaireNew England Journal of Medicine, 1989