Mortality in HIV-1-seropositive women, their spouses and their newly born children during 36 months of follow-up in Kinshasa, Zaïre.
OBJECTIVE
To calculate 3-year mortality rates in HIV-1-seropositive and HIV-1-seronegative mothers, their newborn children and the fathers of these children.


METHODS
Longitudinal cohort study of HIV-1-seropositive, age and parity-matched HIV-1-seronegative pregnant women, their newborn babies and the fathers of these children.


METHODS
Obstetric ward and follow-up clinic at a large municipal hospital in Kinshasa, Zaïre.


METHODS
A total of 335 newborn children and their 327 HIV-1-seropositive mothers and 341 newborn children and their 337 HIV-1-seronegative mothers and the fathers of these children.


METHODS
Rates of vertical HIV-1 transmission and maternal, paternal and early childhood mortality.


RESULTS
The lower and upper bounds of vertical transmission were 27 and 50%, respectively. The 3-year mortality rate was 44% in children with vertically acquired HIV-1 infection, 25% in children with HIV-1-seropositive mothers and indeterminant HIV-1 infection status, and 6% in uninfected children with HIV-1-seronegative mothers. HIV-1-seropositive women who transmitted HIV-1 infection to their most recently born child had lost a greater number of previously born children (mean, 1.5 versus 0.5; P < 0.05), were more likely to have had AIDS at delivery (25 versus 12%; P < 0.01) and were more likely to die during follow-up (22 versus 9%; P < 0.01) than HIV-1-seropositive women who did not transmit HIV-1 infection to their newborn child. Twenty-five out of 239 (10.4%) fathers of children with HIV-1-seropositive mothers, not lost to follow-up, died compared with three out of 310 (1%) fathers of children with HIV-1-seronegative mothers (P < 0.01).


CONCLUSIONS
Families in Kinshasa, Zaïre, in which the mother was HIV-1-seropositive experienced a five to 10-fold higher maternal, paternal and early childhood mortality rate than families in which the mother was HIV-1-seronegative.
Ryder
R W
RW
Project SIDA, Kinshasa, Zaïre.
Nsuami
M
M
Nsa
W
W
Kamenga
M
M
Badi
N
N
Utshudi
M
M
Heyward
W L
WL
D000163:Acquired Immunodeficiency Syndrome / Q000401:mortality; D000328:Adult; D015331:Cohort Studies; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D004200:Diseases in Twins / Q000453:epidemiology; D005192:Family Health; D005220:Fathers; D005260:Female; D015658:HIV Infections / Q000151:congenital / Q000453:epidemiology / Q000635:transmission; D006679:HIV Seropositivity / Q000401:mortality*; D015497:HIV-1; D006801:Humans; D007231:Infant, Newborn; D015993:Life Tables; D008297:Male; D010298:Parity; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D011446:Prospective Studies; D012747:Sexual Partners; D016019:Survival Analysis