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Risk factors for in utero or intrapartum mother-to-child transmission of human immunodeficiency virus type 1 in Thailand.
- Source :
-
The Journal of infectious diseases [J Infect Dis] 2007 Dec 01; Vol. 196 (11), pp. 1629-36. Date of Electronic Publication: 2007 Oct 25. - Publication Year :
- 2007
-
Abstract
- Background: The identification of risk factors for in utero and intrapartum transmission of human immunodeficiency virus type 1 (HIV-1) is crucial to the design and understanding of preventive interventions.<br />Methods: The randomized Perinatal HIV Prevention Trial-1 enrolled 1437 pregnant women and their non-breast-fed infants, to compare the efficacy of various durations of zidovudine prophylaxis. Using univariate and multivariate logistic regression analyses, we studied the role that factors known or occurring at various times during gestation or delivery play in in utero and intrapartum transmission.<br />Results: Variables independently associated with in utero transmission were HIV-1 load >35,000 copies/mL (adjusted odds ratio [AOR], 4.2) and delayed initiation of maternal zidovudine prophylaxis until >31.4 weeks gestation (AOR, 3.0). Variables associated with intrapartum transmission were HIV-1 load >10,000 copies/mL (AOR, 3.8 for 10,000-35,000 copies/mL and 7.1 for >35,000 copies/mL), induction of labor (AOR, 2.6), and premature labor with tocolysis (AOR, 15.1).<br />Conclusions: With the exception of very high HIV-1 load, risk factors for in utero transmission were different from those for intrapartum transmission. Optimal prophylactic interventions must address each of the major risk factors, with appropriate timing.
- Subjects :
- Adult
Analysis of Variance
Female
HIV Infections epidemiology
HIV-1
Humans
Incidence
Infant, Newborn
Logistic Models
Male
Odds Ratio
Parturition
Pregnancy
Pregnancy Complications, Infectious virology
Risk Assessment
Risk Factors
Thailand epidemiology
Treatment Outcome
Viral Load
Anti-HIV Agents therapeutic use
Fetal Diseases prevention & control
Fetal Diseases virology
HIV Infections prevention & control
HIV Infections transmission
Infectious Disease Transmission, Vertical prevention & control
Pregnancy Complications, Infectious drug therapy
Zidovudine therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 0022-1899
- Volume :
- 196
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- The Journal of infectious diseases
- Publication Type :
- Academic Journal
- Accession number :
- 18008246
- Full Text :
- https://doi.org/10.1086/522009