title: Increased risk of intrauterine transmission of HIV-1 associated with granulocyte elastase in endocervical mucus.
abstract: BACKGROUND
  One of the remaining challenges in the prevention of mother-to-child transmission of HIV is to reduce the risk of the transmission during pregnancy. It remains to be investigated which factors affect intrauterine HIV transmission and how they can be identified and addressed during pregnancy.
  
  
  METHODS
  Granulocyte elastase in the endocervical mucus of HIV-positive pregnant women in Zambia was measured, and its association with intrauterine transmission of HIV-1 from the mother to the fetus was investigated.
  
  
  RESULTS
  The intrauterine transmission rate determined by polymerase chain reaction assay of DNA from neonates at birth was 15.3%. The risk for intrauterine transmission was 8.65-fold higher in women who were positive for granulocyte elastase than in those who were negative.
  
  
  CONCLUSIONS
  We suggest that the women showing positive granulocyte elastase at delivery be strongly suspected of having and if having had chorioamnionitis during pregnancy, which could affect the intrauterine transmission of HIV.
authors.affiliation: Department of Obstetrics and Gynecology, University Teaching Hospital, Lusaka, Zambia.
authors.forename: Christine
authors.initials: C
authors.lastname: Kaseba-Sata
authors.forename: Francis
authors.initials: F
authors.lastname: Kasolo
authors.forename: Koji
authors.initials: K
authors.lastname: Ichiyama
authors.forename: Satoshi
authors.initials: S
authors.lastname: Mitarai
authors.forename: Ayako
authors.initials: A
authors.lastname: Nishiyama
authors.forename: Naohiro
authors.initials: N
authors.lastname: Kanayama
authors.forename: Naomi
authors.initials: N
authors.lastname: Wakasugi
mesh_terms: D002582:Cervix Mucus / Q000201:enzymology*; D005260:Female; D006679:HIV Seropositivity / Q000150:complications / Q000453:epidemiology* / Q000635:transmission*; D006784:Hospitals, Teaching; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D019272:Leukocyte Elastase / Q000032:analysis*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D002575:Uterine Cervicitis / Q000150:complications / Q000175:diagnosis; D015024:Zambia
chemical_list: D019272:Leukocyte Elastase