Timing and determinants of mother-to-child transmission of HIV in Nigeria.
OBJECTIVE
To characterize the timing and determinants of mother-to-child transmission (MTCT) of HIV among mothers receiving single-dose nevirapine to prevent MTCT in Nigeria.


METHODS
Three hundred and seventy-one HIV-infected mothers and their infants were followed from birth, at 1 week, and at 1, 3, 6, and 12 months. Risks of in utero (IU), intrapartum (IP/EPP), and postnatal (PP) transmission were quantified using conditional Cox regressions.


RESULTS
Maternal viral load was the only risk factor for IU transmission after controlling for known risk factors. Low birth weight, premature birth, mixed feeding, and maternal viral load were associated with IP/EPP transmission. Increased PP transmission was associated with low birth weight and mixed feeding. At 6 months, mixed-fed infants were more likely to acquire infection than formula-fed infants (hazard ratio=5.74; 95% CI, 1.26-26.2).


CONCLUSIONS
Risk factors for IU transmission differed from those of IP and PP transmission. Reducing mixed feeding and low birth weight delivery among HIV-infected mothers can further decrease IP and PP transmission.
Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA. mcharurat@ihv.umaryland.edu
Man
M
Charurat
Pam
P
Datong
Bitrus
B
Matawal
Anuli
A
Ajene
William
W
Blattner
Alash'le
A
Abimiku
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001724:Birth Weight; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D007225:Infant Food; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D019829:Nevirapine / Q000627:therapeutic use*; D009549:Nigeria; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control / Q000821:virology; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors; D019562:Viral Load; D055815:Young Adult
D019380:Anti-HIV Agents; D019829:Nevirapine