Distinct risk factors for intrauterine and intrapartum human immunodeficiency virus transmission and consequences for disease progression in infected children

Louise Kuhn, Richard W. Steketee, Jeremy Weedon, Elaine J. Abrams, Genevieve Lambert, Marukh Bamji, Ellie Schoenbaum, John Farley, Steve R. Nesheim, Paul Palumbo, R. J. Simonds, Donald M. Thea

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

Predictors and prognosis of intrauterine and intrapartum human immunodeficiency virus (HIV) transmission were investigated among 432 children of HIV-infected women in the Perinatal AIDS Collaborative Transmission Study. Timing of transmission was inferred from polymerase chain reaction or vital culture within 2 days of birth. Proportions of infections due to intrauterine transmission were similar among women using (29%) or not using zidovudine (30%). Preterm delivery was strongly associated with intrapartum transmission (relative risk, 3.7; 95% confidence interval [CI], 2.2-6.1), particularly among infants delivered longer after membrane rupture, but was not associated with intrauterine transmission. Progression to AIDS or death increased 2.5-fold (95% CI, 1.1-5.8) among intrauterine infected children, adjusting for preterm delivery, and maternal CD4 cell count. Early transmission appears unlikely to explain instances of zidovudine failure. Preterm infants may be more vulnerable to HIV acquisition at delivery, especially if membrane rupture is prolonged. Intrauterine infection does not appear to increase risk of preterm delivery.

Original languageEnglish (US)
Pages (from-to)52-58
Number of pages7
JournalJournal of Infectious Diseases
Volume179
Issue number1
DOIs
StatePublished - 1999
Externally publishedYes

Fingerprint

Disease Progression
Zidovudine
HIV
Rupture
Acquired Immunodeficiency Syndrome
Confidence Intervals
Membranes
CD4 Lymphocyte Count
Infection
Premature Infants
Mothers
Parturition
Polymerase Chain Reaction

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Immunology

Cite this

Distinct risk factors for intrauterine and intrapartum human immunodeficiency virus transmission and consequences for disease progression in infected children. / Kuhn, Louise; Steketee, Richard W.; Weedon, Jeremy; Abrams, Elaine J.; Lambert, Genevieve; Bamji, Marukh; Schoenbaum, Ellie; Farley, John; Nesheim, Steve R.; Palumbo, Paul; Simonds, R. J.; Thea, Donald M.

In: Journal of Infectious Diseases, Vol. 179, No. 1, 1999, p. 52-58.

Research output: Contribution to journalArticle

Kuhn, L, Steketee, RW, Weedon, J, Abrams, EJ, Lambert, G, Bamji, M, Schoenbaum, E, Farley, J, Nesheim, SR, Palumbo, P, Simonds, RJ & Thea, DM 1999, 'Distinct risk factors for intrauterine and intrapartum human immunodeficiency virus transmission and consequences for disease progression in infected children', Journal of Infectious Diseases, vol. 179, no. 1, pp. 52-58. https://doi.org/10.1086/314551
Kuhn, Louise ; Steketee, Richard W. ; Weedon, Jeremy ; Abrams, Elaine J. ; Lambert, Genevieve ; Bamji, Marukh ; Schoenbaum, Ellie ; Farley, John ; Nesheim, Steve R. ; Palumbo, Paul ; Simonds, R. J. ; Thea, Donald M. / Distinct risk factors for intrauterine and intrapartum human immunodeficiency virus transmission and consequences for disease progression in infected children. In: Journal of Infectious Diseases. 1999 ; Vol. 179, No. 1. pp. 52-58.
@article{aa20d9440c98406caf06ae48e61cfffa,
title = "Distinct risk factors for intrauterine and intrapartum human immunodeficiency virus transmission and consequences for disease progression in infected children",
abstract = "Predictors and prognosis of intrauterine and intrapartum human immunodeficiency virus (HIV) transmission were investigated among 432 children of HIV-infected women in the Perinatal AIDS Collaborative Transmission Study. Timing of transmission was inferred from polymerase chain reaction or vital culture within 2 days of birth. Proportions of infections due to intrauterine transmission were similar among women using (29{\%}) or not using zidovudine (30{\%}). Preterm delivery was strongly associated with intrapartum transmission (relative risk, 3.7; 95{\%} confidence interval [CI], 2.2-6.1), particularly among infants delivered longer after membrane rupture, but was not associated with intrauterine transmission. Progression to AIDS or death increased 2.5-fold (95{\%} CI, 1.1-5.8) among intrauterine infected children, adjusting for preterm delivery, and maternal CD4 cell count. Early transmission appears unlikely to explain instances of zidovudine failure. Preterm infants may be more vulnerable to HIV acquisition at delivery, especially if membrane rupture is prolonged. Intrauterine infection does not appear to increase risk of preterm delivery.",
author = "Louise Kuhn and Steketee, {Richard W.} and Jeremy Weedon and Abrams, {Elaine J.} and Genevieve Lambert and Marukh Bamji and Ellie Schoenbaum and John Farley and Nesheim, {Steve R.} and Paul Palumbo and Simonds, {R. J.} and Thea, {Donald M.}",
year = "1999",
doi = "10.1086/314551",
language = "English (US)",
volume = "179",
pages = "52--58",
journal = "Journal of Infectious Diseases",
issn = "0022-1899",
publisher = "Oxford University Press",
number = "1",

}

TY - JOUR

T1 - Distinct risk factors for intrauterine and intrapartum human immunodeficiency virus transmission and consequences for disease progression in infected children

AU - Kuhn, Louise

AU - Steketee, Richard W.

AU - Weedon, Jeremy

AU - Abrams, Elaine J.

AU - Lambert, Genevieve

AU - Bamji, Marukh

AU - Schoenbaum, Ellie

AU - Farley, John

AU - Nesheim, Steve R.

AU - Palumbo, Paul

AU - Simonds, R. J.

AU - Thea, Donald M.

PY - 1999

Y1 - 1999

N2 - Predictors and prognosis of intrauterine and intrapartum human immunodeficiency virus (HIV) transmission were investigated among 432 children of HIV-infected women in the Perinatal AIDS Collaborative Transmission Study. Timing of transmission was inferred from polymerase chain reaction or vital culture within 2 days of birth. Proportions of infections due to intrauterine transmission were similar among women using (29%) or not using zidovudine (30%). Preterm delivery was strongly associated with intrapartum transmission (relative risk, 3.7; 95% confidence interval [CI], 2.2-6.1), particularly among infants delivered longer after membrane rupture, but was not associated with intrauterine transmission. Progression to AIDS or death increased 2.5-fold (95% CI, 1.1-5.8) among intrauterine infected children, adjusting for preterm delivery, and maternal CD4 cell count. Early transmission appears unlikely to explain instances of zidovudine failure. Preterm infants may be more vulnerable to HIV acquisition at delivery, especially if membrane rupture is prolonged. Intrauterine infection does not appear to increase risk of preterm delivery.

AB - Predictors and prognosis of intrauterine and intrapartum human immunodeficiency virus (HIV) transmission were investigated among 432 children of HIV-infected women in the Perinatal AIDS Collaborative Transmission Study. Timing of transmission was inferred from polymerase chain reaction or vital culture within 2 days of birth. Proportions of infections due to intrauterine transmission were similar among women using (29%) or not using zidovudine (30%). Preterm delivery was strongly associated with intrapartum transmission (relative risk, 3.7; 95% confidence interval [CI], 2.2-6.1), particularly among infants delivered longer after membrane rupture, but was not associated with intrauterine transmission. Progression to AIDS or death increased 2.5-fold (95% CI, 1.1-5.8) among intrauterine infected children, adjusting for preterm delivery, and maternal CD4 cell count. Early transmission appears unlikely to explain instances of zidovudine failure. Preterm infants may be more vulnerable to HIV acquisition at delivery, especially if membrane rupture is prolonged. Intrauterine infection does not appear to increase risk of preterm delivery.

UR - http://www.scopus.com/inward/record.url?scp=0032929576&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032929576&partnerID=8YFLogxK

U2 - 10.1086/314551

DO - 10.1086/314551

M3 - Article

VL - 179

SP - 52

EP - 58

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

SN - 0022-1899

IS - 1

ER -