Predictive markers for mother-to-child transmission of HIV-1 in Dar es Salaam, Tanzania.
The aim of this study was to determine immunological factors associated with increased risk of mother-to-child transmission of HIV-1 that could be used as predictive markers in Tanzanian women. One hundred and thirty-eight HIV-1-seropositive and 117-seronegative mothers and their newborns were recruited at delivery and followed up at Muhimbili Medical Centre in Dar es Salaam, Tanzania. Blood specimens from the mothers were analyzed for HIV-1 p24 antigen, beta 2-microglobulin (B2M), T-lymphocyte subsets, and presence of viral DNA in blood mononuclear cells by the polymerase chain reaction (PCR). Among 138 seropositive mothers, 30 (21.7%) had transmitted HIV-1 to their children, as shown by a positive PCR in the child. The vertical transmission rate was significantly higher in women with a percentage of CD4 lymphocytes < or = 20 (eight of 24, 33%) or a level of B2M > or = 2 mg/L (21 of 62, 34%) than in women with a higher percentage of CD4 lymphocytes (10 of 73, 14%) or a lower level of B2M (eight of 57, 14%) (p = 0.034 and 0.018, respectively). In eight of 18 (44%) transmitting mothers the percentage of CD4 lymphocytes was < or = 20, and in 21 of 29 (72%) transmitting mothers the B2M level was > or = 2 mg/L. In women with both a low percentage of CD4 lymphocytes (< or = 20) and a high level of B2M (> or = 2 mg/L), the vertical transmission rate was 54%.(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Immunology, Swedish Institute for Infectious Disease Control, Stockholm.
U
U
Bredberg-Rådén
W
W
Urassa
E
E
Urassa
E
E
Lyamuya
G
G
Msemo
G
G
Kawo
T
T
Kazimoto
A
A
Massawe
O
O
Grankvist
E
E
Mbena
D015415:Biomarkers; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016655:HIV Core Protein p24 / Q000097:blood; D006679:HIV Seropositivity / Q000453:epidemiology / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D016176:T-Lymphocyte Subsets; D013636:Tanzania; D001613:beta 2-Microglobulin / Q000032:analysis
D015415:Biomarkers; D016655:HIV Core Protein p24; D001613:beta 2-Microglobulin