Mother-to-child transmission of human immunodeficiency virus type 1: report from the Nairobi Study.
Mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) is a significant problem in countries with endemic HIV-1 infection. Between 1986 and 1991, 365 children of HIV-1-infected mothers and 363 control children were studied in Kenya. The overall risk of transmission from mother to child, determined by serologic evidence of infection by age > or = 12 months and excess mortality in the HIV-1-exposed group, was 42.8% (range, 27.6%-62.2%). Marriage was the only maternal characteristic associated with transmission (odds ratio, 2.2; 95% confidence interval, 1.2-4.2; P < .05). Children who experienced growth failure were more likely to be infected. In 44% of children ultimately infected, the pattern of antibody response implied intrapartum or postnatal exposure to HIV-1. Of potential postnatal exposures examined, duration of breast-feeding beyond age 15 months and the mother being married were independently associated with increased risk of infection and seroconversion of children. The percentage of HIV infection attributable to breast-feeding > or = 15 months was 32%. The frequency of mother-to-child transmission of HIV-1 was high; a substantial proportion of infection occurred postnatally, possibly through breast-feeding.
World Health Organization Collaborating Centre for Research and Training in Sexually Transmitted Diseases, Department of Medical Microbiology, University of Nairobi, Kenya.
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Datta
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Embree
J K
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Kreiss
J O
JO
Ndinya-Achola
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Braddick
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Temmerman
N J
NJ
Nagelkerke
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Maitha
K K
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Holmes
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Piot
D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000635:transmission*; D001942:Breast Feeding; D005260:Female; D015497:HIV-1; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D007630:Kenya / Q000453:epidemiology; D015999:Multivariate Analysis; D011247:Pregnancy; D012307:Risk Factors