title: Chlamydia and Gonorrhea in HIV-Infected Pregnant Women and Infant HIV Transmission.
abstract: BACKGROUND
  Sexually transmitted infections (STIs) such as Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) can lead to adverse pregnancy and neonatal outcomes. The prevalence of STIs and its association with HIV mother-to-child transmission (MTCT) were evaluated in a substudy analysis from a randomized, multicenter clinical trial.
  
  
  METHODS
  Urine samples from HIV-infected pregnant women collected at the time of labor and delivery were tested using polymerase chain reaction testing for the detection of CT and NG (Xpert CT/NG; Cepheid, Sunnyvale, CA). Infant HIV infection was determined by HIV DNA polymerase chain reaction at 3 months.
  
  
  RESULTS
  Of the 1373 urine specimens, 249 (18.1%) were positive for CT and 63 (4.6%) for NG; 35 (2.5%) had both CT and NG detected. Among 117 cases of HIV MTCT (8.5% transmission), the lowest transmission rate occurred among infants born to CT- and NG-uninfected mothers (8.1%) as compared with those infected with only CT (10.7%) and both CT and NG (14.3%; P = 0.04). Infants born to CT-infected mothers had almost a 1.5-fold increased risk for HIV acquisition (odds ratio, 1.47; 95% confidence interval, 0.9-2.3; P = 0.09).
  
  
  CONCLUSIONS
  This cohort of HIV-infected pregnant women is at high risk for infection with CT and NG. Analysis suggests that STIs may predispose to an increased HIV MTCT risk in this high-risk cohort of HIV-infected women.
authors.affiliation: From the *David Geffen UCLA School of Medicine, Los Angeles, CA; †Fielding School of Public Health, UCLA, Los Angeles, CA; ‡Westat, Rockville, MD; §Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil; ¶Office of the Global AIDS Coordinator, US Department of State, Washington, DC; ∥Cepheid, Sunnyvale, CA; **Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD; ††Hospital Geral de Nova Iguaçu, Nova Iguaçu, RJ, Brazil; and ‡‡Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, Brazil.
authors.forename: Kristina
authors.initials: K
authors.lastname: Adachi
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Klausner
authors.forename: Claire C
authors.initials: CC
authors.lastname: Bristow
authors.forename: Jiahong
authors.initials: J
authors.lastname: Xu
authors.forename: Bonnie
authors.initials: B
authors.lastname: Ank
authors.forename: Mariza G
authors.initials: MG
authors.lastname: Morgado
authors.forename: D Heather
authors.initials: DH
authors.lastname: Watts
authors.forename: Fred
authors.initials: F
authors.lastname: Weir
authors.forename: David
authors.initials: D
authors.lastname: Persing
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Mofenson
authors.forename: Valdilea G
authors.initials: VG
authors.lastname: Veloso
authors.forename: Jose Henrique
authors.initials: JH
authors.lastname: Pilotto
authors.forename: Esau
authors.initials: E
authors.lastname: Joao
authors.forename: Karin
authors.initials: K
authors.lastname: Nielsen-Saines
mesh_terms: D000328:Adult; D001118:Argentina / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D002690:Chlamydia Infections / Q000276:immunology / Q000517:prevention & control / Q000635:transmission*; D005260:Female; D006069:Gonorrhea / Q000276:immunology / Q000517:prevention & control / Q000635:transmission*; D006679:HIV Seropositivity / Q000150:complications* / Q000276:immunology / Q000635:transmission; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D009035:Mothers; D056990:Post-Exposure Prophylaxis; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D037841:Pregnant People; D015995:Prevalence; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D014481:United States / Q000453:epidemiology