Influence of other maternal variables on the relationship between maternal virus load and mother-to-infant transmission of human immunodeficiency virus type 1.
To assess the relationship between maternal human immunodeficiency virus (HIV) type 1 RNA level, other important covariates, and mother-to-infant (vertical) transmission of HIV-1, third trimester repository specimens from 160 HIV-1-seropositive women enrolled in the Mothers and Infants Cohort Study between 1986 and 1991 were assayed in batch for HIV-1 RNA. A significant association between peripheral blood HIV-1 RNA level and vertical transmission remained after controlling for CD4 cell level, duration of ruptured membranes, "hard" drug (cocaine and heroin) use, and frequency of sexual activity during pregnancy. However, the association was attenuated among women with advanced HIV infection and those with a high frequency of sexual activity during pregnancy. In these settings, interventions that target risk factors other than virus load may be particularly important for preventing vertical transmission of HIV-1.
Burns
D N
DN
Pediatric, Adolescent, and Maternal AIDS Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892-7510, USA.
Landesman
S
S
Wright
D J
DJ
Waters
D
D
Mitchell
R M
RM
Rubinstein
A
A
Willoughby
A
A
Goedert
J J
JJ
D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000635:transmission*; D018791:CD4 Lymphocyte Count; D003042:Cocaine; D015331:Cohort Studies; D005260:Female; D016655:HIV Core Protein p24 / Q000032:analysis; D006679:HIV Seropositivity; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification; D006556:Heroin Dependence; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data; D009293:Opioid-Related Disorders; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011263:Pregnancy Trimester, Third; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D012307:Risk Factors; D012725:Sexual Behavior
D016655:HIV Core Protein p24; D012367:RNA, Viral; D003042:Cocaine