title: Serum level of maternal human immunodeficiency virus (HIV) RNA, infant mortality, and vertical transmission of HIV in Zimbabwe.
abstract: Maternal human immunodeficiency virus (HIV) RNA load, vertical transmission of subtype C HIV, and infant mortality were examined in 251 HIV-seropositive women and their infants in Zimbabwe. Demographic characteristics, health and medical histories, serum HIV RNA loads, and CD4+ lymphocyte counts for mothers were examined by logistic regression analysis to determine significant risk factors and their odds ratios for transmission and infant mortality. Tenfold (1 log10) incremental increases in maternal HIV RNA were associated with a 1.9-fold increase (95% confidence interval [CI], 1.2-2.9) in transmission and a 2.1-fold increase (95% CI, 1.3-3.5) in infant mortality (P<.01). Maternal CD4 cell counts and demographic and medical characteristics were not significant predictors of transmission. However, maternal CD4 cell counts below the median (400/mm3) were significantly associated with infant mortality (P=. 035, Fisher's exact test). The maternal level of serum HIV is an important determinant of vertical transmission and infant mortality in subtype C infection in Zimbabwe.
authors.affiliation: Associate Professor of Medicine, Center for AIDS Research, Division of Infectious Disease and Geographic Medicine, Stanford University Medical Center, CA 94305, USA. davidkk@leland.stanford.edu
authors.forename: D A
authors.initials: DA
authors.lastname: Katzenstein
authors.forename: M
authors.initials: M
authors.lastname: Mbizvo
authors.forename: L
authors.initials: L
authors.lastname: Zijenah
authors.forename: T
authors.initials: T
authors.lastname: Gittens
authors.forename: M
authors.initials: M
authors.lastname: Munjoma
authors.forename: D
authors.initials: D
authors.lastname: Hill
authors.forename: S
authors.initials: S
authors.lastname: Madzime
authors.forename: Y
authors.initials: Y
authors.lastname: Maldonado
mesh_terms: D018791:CD4 Lymphocyte Count; D002675:Child, Preschool; D003710:Demography; D005260:Female; D005544:Forecasting; D006679:HIV Seropositivity / Q000401:mortality* / Q000635:transmission*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D016015:Logistic Models; D012367:RNA, Viral / Q000097:blood*; D014944:World Health Organization; D015030:Zimbabwe / Q000453:epidemiology
chemical_list: D012367:RNA, Viral