BACKGROUND:Maternal human immunodeficiency virus (HIV) RNA load, CD4 cell count, breast-feeding, antiretroviral use, and malaria are well-established factors associated with mother-to-child transmission (MTCT) of HIV; the role of maternal tuberculosis (TB), however, has not been well established. METHODS: The study population was 783 HIV-infected Indian mother-infant pair participants in randomized and ancillary HIV-infected cohorts of the Six Week Extended-DoseNevirapine (SWEN) Study, a study comparing extended nevirapine versus single-dose nevirapine, to reduce MTCT of HIV among breast-fed infants. Using multivariable logistic regression, we assessed the impact of maternal TB occurring during pregnancy and through 12 months after delivery on risk of MTCT. RESULTS: Of 783 mothers, 3 had prevalent TB and 30 had incident TB at 12 months after delivery. Of 33 mothers with TB, 10 (30%) transmitted HIV to their infants in comparison with 87 of 750 mothers without TB (12%; odds ratio [OR], 3.31; 95% confidence interval [CI], 1.53-7.29; P = .02). In multivariable analysis, maternal TB was associated with 2.51-fold (95% CI, 1.05-6.02; P = .04) increased odds of HIV transmission adjusting for maternal factors (viral load, CD4 cell count, and antiretroviral therapy) and infant factors (breast-feeding duration, infant nevirapine administration, gestational age, and birth weight) associated with MTCT of HIV. CONCLUSIONS:Maternal TB is associated with increased MTCT of HIV. Prevention of TB among HIV-infected mothers should be a high priority for communities with significant HIV/TB burden.
RCT Entities:
BACKGROUND:Maternal human immunodeficiency virus (HIV) RNA load, CD4 cell count, breast-feeding, antiretroviral use, and malaria are well-established factors associated with mother-to-child transmission (MTCT) of HIV; the role of maternal tuberculosis (TB), however, has not been well established. METHODS: The study population was 783 HIV-infected Indian mother-infant pair participants in randomized and ancillary HIV-infected cohorts of the Six Week Extended-Dose Nevirapine (SWEN) Study, a study comparing extended nevirapine versus single-dose nevirapine, to reduce MTCT of HIV among breast-fed infants. Using multivariable logistic regression, we assessed the impact of maternal TB occurring during pregnancy and through 12 months after delivery on risk of MTCT. RESULTS: Of 783 mothers, 3 had prevalent TB and 30 had incident TB at 12 months after delivery. Of 33 mothers with TB, 10 (30%) transmitted HIV to their infants in comparison with 87 of 750 mothers without TB (12%; odds ratio [OR], 3.31; 95% confidence interval [CI], 1.53-7.29; P = .02). In multivariable analysis, maternal TB was associated with 2.51-fold (95% CI, 1.05-6.02; P = .04) increased odds of HIV transmission adjusting for maternal factors (viral load, CD4 cell count, and antiretroviral therapy) and infant factors (breast-feeding duration, infantnevirapine administration, gestational age, and birth weight) associated with MTCT of HIV. CONCLUSIONS: Maternal TB is associated with increased MTCT of HIV. Prevention of TB among HIV-infected mothers should be a high priority for communities with significant HIV/TB burden.
Authors: Z Toossi; H Mayanja-Kizza; C S Hirsch; K L Edmonds; T Spahlinger; D L Hom; H Aung; P Mugyenyi; J J Ellner; C W Whalen Journal: Clin Exp Immunol Date: 2001-02 Impact factor: 4.330
Authors: D Goletti; D Weissman; R W Jackson; N M Graham; D Vlahov; R S Klein; S S Munsiff; L Ortona; R Cauda; A S Fauci Journal: J Immunol Date: 1996-08-01 Impact factor: 5.422
Authors: Saurabh Mehta; David J Hunter; Ferdinand M Mugusi; Donna Spiegelman; Karim P Manji; Edward L Giovannucci; Ellen Hertzmark; Gernard I Msamanga; Wafaie W Fawzi Journal: J Infect Dis Date: 2009-10-01 Impact factor: 5.226
Authors: Jason M Brenchley; David A Price; Timothy W Schacker; Tedi E Asher; Guido Silvestri; Srinivas Rao; Zachary Kazzaz; Ethan Bornstein; Olivier Lambotte; Daniel Altmann; Bruce R Blazar; Benigno Rodriguez; Leia Teixeira-Johnson; Alan Landay; Jeffrey N Martin; Frederick M Hecht; Louis J Picker; Michael M Lederman; Steven G Deeks; Daniel C Douek Journal: Nat Med Date: 2006-11-19 Impact factor: 53.440
Authors: Kevin L Steiner; Indu Malhotra; Peter L Mungai; Eric M Muchiri; Arlene E Dent; Christopher L King Journal: Virology Date: 2012-01-26 Impact factor: 3.616
Authors: S R Jonnalagadda; E Brown; B Lohman-Payne; D Wamalwa; C Farquhar; G C John-Stewart Journal: Int J Tuberc Lung Dis Date: 2013-12 Impact factor: 2.373
Authors: Sylvia M LaCourse; Anjuli D Wagner; Lisa M Cranmer; Audrey Copeland; Elizabeth Maleche-Obimbo; Barbra A Richardson; Daniel Matemo; John Kinuthia; Grace John-Stewart Journal: J Acquir Immune Defic Syndr Date: 2019-09-01 Impact factor: 3.731
Authors: V Mave; D Kadam; A Kinikar; N Gupte; D Bhattacharya; R Bharadwaj; K McIntire; V Kulkarni; U Balasubramanian; N Suryavanshi; C Thio; P Deshpande; J Sastry; R Bollinger; A Gupta; R Bhosale Journal: HIV Med Date: 2014-01-14 Impact factor: 3.180
Authors: Erica L Johnson; Chanie L Howard; Joy Thurman; Kyle Pontiff; Elan S Johnson; Rana Chakraborty Journal: J Infect Dis Date: 2014-07-31 Impact factor: 5.226