title: Comparative prediction of perinatal human immunodeficiency virus type 1 transmission, using multiple virus load markers.
abstract: Maternal plasma human immunodeficiency virus (HIV) type 1 RNA load has a role in perinatal transmission, but significant overlap in the range of plasma virus loads among transmitters and nontransmitters is often observed, which makes it difficult to predict transmission outcome. We measured several virus markers in a drug-naive population of HIV-1-infected mothers in Botswana. Maternal plasma HIV-1 RNA load, peripheral blood mononuclear cell-associated blood HIV-1 DNA load, and cervicovaginal fluid (CVF) HIV-1 DNA load were determined using quantitative real-time polymerase chain reaction. The overall rate of transmission among these mother-infant pairs was 35.7%. Median infant age was 2.5 months. An association between increased plasma HIV-1 RNA load and perinatal transmission was observed (odds ratio [OR], 2.20/1-log virus load; 95% confidence interval [CI], 1.15-4.18). However, the association between increased blood HIV-1 DNA load and perinatal transmission was stronger (OR, 10.30; 95% CI, 2.11-50.38). When blood HIV-1 DNA load was combined with CVF HIV-1 DNA load, the association with transmission increased (OR, 25.0; 95% CI 2.73-228.60).
authors.affiliation: Harvard School of Public Health, Boston, Massachusetts, USA. mmontano@bu.edu.
authors.forename: Monty
authors.initials: M
authors.lastname: Montano
authors.forename: Matthew
authors.initials: M
authors.lastname: Russell
authors.forename: Peter
authors.initials: P
authors.lastname: Gilbert
authors.forename: Ibou
authors.initials: I
authors.lastname: Thior
authors.forename: Shahin
authors.initials: S
authors.lastname: Lockman
authors.forename: Roger
authors.initials: R
authors.lastname: Shapiro
authors.forename: Su-Yuan
authors.initials: SY
authors.lastname: Chang
authors.forename: Tun Hou
authors.initials: TH
authors.lastname: Lee
authors.forename: Max
authors.initials: M
authors.lastname: Essex
mesh_terms: D000328:Adult; D001902:Botswana / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000453:epidemiology / Q000635:transmission*; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data; D007963:Leukocytes, Mononuclear / Q000821:virology; D011247:Pregnancy; D011533:Proviruses / Q000302:isolation & purification*; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D012424:Rural Population; D014621:Vagina / Q000378:metabolism / Q000821:virology; D019562:Viral Load / Q000379:methods* / Q000706:statistics & numerical data
chemical_list: D004279:DNA, Viral; D012367:RNA, Viral