OBJECTIVE: We investigated gender-specific risks of mother-to-child transmission (MTCT) at birth and at 6 to 8 weeks among infants born to HIV-infected African women. DESIGN: Follow-up study of infants enrolled in 2 randomized, phase III, clinical trials to prevent MTCT, conducted in Blantyre, Malawi, in southeast Africa. METHODS: Infants were enrolled at birth and monitored postnatally, and their HIV status was assessed at birth and at 6 to 8 weeks (assessment beyond 6-8 weeks is ongoing). Statistical analyses were stratified according to gender, and comparisons were made with descriptive, univariate, and multivariate statistical tests. MTCT was estimated at birth and at 6 to 8 weeks among infants who were not infected at birth. RESULTS: Overall, 966 boys and 998 girls were enrolled. The rate of HIV transmission at birth was 9.5% (187 of 1964 infants). However, at birth significantly more girls (12.6%) than boys (6.3%) were infected with HIV. This association remained significant after controlling for maternal viral load and other factors. Among infants who were uninfected at birth, 8.7% (135 of 1554 infants) acquired HIV by 6 to 8 weeks; of these infants, more girls acquired HIV (10.0%), compared with boys (7.4%). CONCLUSIONS:Female infants may be more susceptible to HIV infection before birth and continuing after birth. Alternatively, in utero mortality rates of HIV-infected male infants may be disproportionately higher and thus more HIV-infected female infants are born. In areas of sub-Saharan Africa, where HIV infection rates are high among women of reproductive age, the magnitude of the gender transmission differences observed in this study could have clinical, preventive, and demographic implications.
RCT Entities:
OBJECTIVE: We investigated gender-specific risks of mother-to-child transmission (MTCT) at birth and at 6 to 8 weeks among infants born to HIV-infected African women. DESIGN: Follow-up study of infants enrolled in 2 randomized, phase III, clinical trials to prevent MTCT, conducted in Blantyre, Malawi, in southeast Africa. METHODS:Infants were enrolled at birth and monitored postnatally, and their HIV status was assessed at birth and at 6 to 8 weeks (assessment beyond 6-8 weeks is ongoing). Statistical analyses were stratified according to gender, and comparisons were made with descriptive, univariate, and multivariate statistical tests. MTCT was estimated at birth and at 6 to 8 weeks among infants who were not infected at birth. RESULTS: Overall, 966 boys and 998 girls were enrolled. The rate of HIV transmission at birth was 9.5% (187 of 1964 infants). However, at birth significantly more girls (12.6%) than boys (6.3%) were infected with HIV. This association remained significant after controlling for maternal viral load and other factors. Among infants who were uninfected at birth, 8.7% (135 of 1554 infants) acquired HIV by 6 to 8 weeks; of these infants, more girls acquired HIV (10.0%), compared with boys (7.4%). CONCLUSIONS: Female infants may be more susceptible to HIV infection before birth and continuing after birth. Alternatively, in utero mortality rates of HIV-infected male infants may be disproportionately higher and thus more HIV-infected female infants are born. In areas of sub-Saharan Africa, where HIV infection rates are high among women of reproductive age, the magnitude of the gender transmission differences observed in this study could have clinical, preventive, and demographic implications.
Authors: Gernard I Msamanga; Taha E Taha; Alicia M Young; Elizabeth R Brown; Irving F Hoffman; Jennifer S Read; Victor Mudenda; Robert L Goldenberg; Usha Sharma; Moses Sinkala; Wafaie W Fawzi Journal: Am J Trop Med Hyg Date: 2009-04 Impact factor: 2.345
Authors: Quarraisha Abdool Karim; Judith D Auerbach; Simone E Buitendijk; Pedro Cahn; Mirjam J Curno; Catherine Hankins; Elly Katabira; Susan Kippax; Richard Marlink; Joan Marsh; Ana Marusic; Heidi M Nass; Julio Montaner; Elizabeth Pollitzer; Maria Teresa Ruiz-Cantero; Lorraine Sherr; Papa Salif Sow; Kathleen Squires; Mark A Wainberg; Shirin Heidari Journal: J Int AIDS Soc Date: 2012-03-08 Impact factor: 5.396
Authors: Luis M Prieto; Carolina Fernández McPhee; Patricia Rojas; Diana Mazariegos; Eloy Muñoz; Maria José Mellado; África Holguín; María Luisa Navarro; María Isabel González-Tomé; José Tomás Ramos Journal: PLoS One Date: 2017-08-25 Impact factor: 3.240
Authors: Mhairi Maskew; Jacob Bor; William MacLeod; Sergio Carmona; Gayle G Sherman; Matthew P Fox Journal: Lancet HIV Date: 2019-10-01 Impact factor: 16.070
Authors: Masahiko Mori; Emily Adland; Paolo Paioni; Alice Swordy; Luisa Mori; Leana Laker; Maximilian Muenchhoff; Philippa C Matthews; Gareth Tudor-Williams; Nora Lavandier; Anriette van Zyl; Jacob Hurst; Bruce D Walker; Thumbi Ndung'u; Andrew Prendergast; Philip Goulder; Pieter Jooste Journal: PLoS One Date: 2015-07-07 Impact factor: 3.240