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Syphilis in HIV-infected mothers and infants: results from the NICHD/HPTN 040 study.
- Source :
-
The Pediatric infectious disease journal [Pediatr Infect Dis J] 2015 Mar; Vol. 34 (3), pp. e52-7. - Publication Year :
- 2015
-
Abstract
- Background: Untreated syphilis during pregnancy is associated with spontaneous abortion, stillbirth, prematurity and infant mortality. Syphilis may facilitate HIV transmission, which is especially concerning in low- and middle-income countries where both diseases are common.<br />Methods: We performed an analysis of data available from NICHD/HPTN 040 (P1043), a study focused on the prevention of intrapartum HIV transmission to 1684 infants born to 1664 untreated HIV-infected women. This analysis evaluates risk factors and outcomes associated with a syphilis diagnosis in this cohort of HIV-infected women and their infants.<br />Results: Approximately, 10% of women (n=171) enrolled had serological evidence of syphilis without adequate treatment documented and 1.4% infants (n=24) were dually HIV and syphilis infected. Multivariate logistic analysis showed that compared with HIV-infected women, co-infected women were significantly more likely to self-identify as non-white (adjusted odds ratio [AOR] 2.5, 95% CI: 1.5-4.2), to consume alcohol during pregnancy (AOR 1.5, 95% CI: 1.1-2.1) and to transmit HIV to their infants (AOR 2.1, 95% CI: 1.3-3.4), with 88% of HIV infections being acquired in utero. As compared with HIV-infected or HIV-exposed infants, co-infected infants were significantly more likely to be born to mothers with venereal disease research laboratory titersā„1:16 (AOR 3, 95% CI: 1.1-8.2) and higher viral loads (AOR 1.5, 95% CI: 1.1-1.9). Of 6 newborns with symptomatic syphilis, 2 expired shortly after birth, and 2 were HIV-infected.<br />Conclusion: Syphilis continues to be a common co-infection in HIV-infected women and can facilitate in utero transmission of HIV to infants. Most infants are asymptomatic at birth, but those with symptoms have high mortality rates.
- Subjects :
- Adult
Female
HIV Infections diagnosis
HIV Infections prevention & control
Humans
Infant
Infant, Newborn
Pregnancy
Pregnancy Complications, Infectious
Risk Factors
Syphilis diagnosis
Syphilis, Congenital diagnosis
Syphilis, Congenital epidemiology
Young Adult
Coinfection
HIV Infections epidemiology
HIV Infections transmission
Infectious Disease Transmission, Vertical
Syphilis epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1532-0987
- Volume :
- 34
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- The Pediatric infectious disease journal
- Publication Type :
- Academic Journal
- Accession number :
- 25742089
- Full Text :
- https://doi.org/10.1097/INF.0000000000000578