title: Maternal-fetal DNA admixture is associated with intrapartum mother-to-child transmission of HIV-1 in Blantyre, Malawi.
abstract: BACKGROUND
  The mechanism of mother-to-child transmission (MTCT) of HIV-1 is not well described.
  
  
  METHODS
  Of 328 HIV-infected mother-infant pairs, we identified 91 that had discordant angiotensin I-converting enzyme and glutathione S-transferase M1 alleles. Maternal alleles in cord blood were quantified with real-time polymerase chain reaction, as indicators of microtransfusions.
  
  
  RESULTS
  HIV-1 infected infants had more maternal DNA in cord blood than their uninfected counterparts. Increased maternal DNA in cord blood was associated with preterm delivery, low birth weight, and maternal immunosuppression.
  
  
  CONCLUSIONS
  Intrapartum MTCT was associated with placental microtransfusions. The associations among placental microtransfusion, in-utero MTCT, maternal immunosuppression, and poor birth outcome should be further investigated.
authors.affiliation: Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Jesse J
authors.initials: JJ
authors.lastname: Kwiek
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Arney
authors.forename: Visopo
authors.initials: V
authors.lastname: Harawa
authors.forename: Bonnie
authors.initials: B
authors.lastname: Pedersen
authors.forename: Victor
authors.initials: V
authors.lastname: Mwapasa
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Rogerson
authors.forename: Steven R
authors.initials: SR
authors.lastname: Meshnick
mesh_terms: D000483:Alleles; D004247:DNA / Q000235:genetics / Q000302:isolation & purification; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005982:Glutathione Transferase / Q000235:genetics; D006678:HIV; D015658:HIV Infections / Q000235:genetics / Q000635:transmission* / Q000821:virology*; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008295:Malawi; D009035:Mothers; D007703:Peptidyl-Dipeptidase A / Q000235:genetics; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious
chemical_list: D004247:DNA; D005982:Glutathione Transferase; D007703:Peptidyl-Dipeptidase A