OBJECTIVE: The BED assay was developed to estimate the proportion of recent HIV infections in a population. We used the BED assay as a proxy for acute infection to quantify the associated risk of mother-to-child-transmission (MTCT) during pregnancy and delivery. Design A total of 3773 HIV-1 sero-positive women were tested within 96 h of delivery using the BED assay, and CD4 cell count measurements were taken. Mothers were classified according to their likelihood of having recently seroconverted. METHODS: The risk of MTCT in utero and intra-partum was assessed comparing different groups defined by BED and CD4 cell count, adjusting for background factors using multinomial logistic models. RESULTS: Compared with women with BED ≥ 0.8/CD4 ≥ 350 (typical of HIV-1 chronic patients) there was insufficient evidence to conclude that women presenting with BED < 0.8/CD4 ≥ 350 (typical of recent infections) were more likely to transmit in utero [adjusted odds ratio (aOR) = 1.37, 96% confidence interval (CI) 0.90-2.08, P = 0.14], whereas women with BED < 0.8/CD4 200-349 (possibly recently infected patients) had a 2.57 (95% CI 1.39-4.77, P-value < 0.01) odds of transmitting in utero. Women who had BED < 0.8/CD4 < 200 were most likely to transmit in utero (aOR 3.73, 95% CI 1.27-10.96, P = 0.02). BED and CD4 cell count were not predictive of intra-partum infections. CONCLUSIONS: These data provide evidence that in utero transmission of HIV might be higher among women who seroconvert during pregnancy.
OBJECTIVE: The BED assay was developed to estimate the proportion of recent HIV infections in a population. We used the BED assay as a proxy for acute infection to quantify the associated risk of mother-to-child-transmission (MTCT) during pregnancy and delivery. Design A total of 3773 HIV-1 sero-positive women were tested within 96 h of delivery using the BED assay, and CD4 cell count measurements were taken. Mothers were classified according to their likelihood of having recently seroconverted. METHODS: The risk of MTCT in utero and intra-partum was assessed comparing different groups defined by BED and CD4 cell count, adjusting for background factors using multinomial logistic models. RESULTS: Compared with women with BED ≥ 0.8/CD4 ≥ 350 (typical of HIV-1 chronicpatients) there was insufficient evidence to conclude that women presenting with BED < 0.8/CD4 ≥ 350 (typical of recent infections) were more likely to transmit in utero [adjusted odds ratio (aOR) = 1.37, 96% confidence interval (CI) 0.90-2.08, P = 0.14], whereas women with BED < 0.8/CD4 200-349 (possibly recently infected patients) had a 2.57 (95% CI 1.39-4.77, P-value < 0.01) odds of transmitting in utero. Women who had BED < 0.8/CD4 < 200 were most likely to transmit in utero (aOR 3.73, 95% CI 1.27-10.96, P = 0.02). BED and CD4 cell count were not predictive of intra-partum infections. CONCLUSIONS: These data provide evidence that in utero transmission of HIV might be higher among women who seroconvert during pregnancy.
Authors: A Roongpisuthipong; W Siriwasin; R J Simonds; V Sangtaweesin; N Vanprapar; C Wasi; S Singhanati; P Mock; N Young; B Parekh; T D Mastro; N Shaffer Journal: J Acquir Immune Defic Syndr Date: 2001-04-01 Impact factor: 3.731
Authors: Maria J Wawer; Ronald H Gray; Nelson K Sewankambo; David Serwadda; Xianbin Li; Oliver Laeyendecker; Noah Kiwanuka; Godfrey Kigozi; Mohammed Kiddugavu; Thomas Lutalo; Fred Nalugoda; Fred Wabwire-Mangen; Mary P Meehan; Thomas C Quinn Journal: J Infect Dis Date: 2005-03-30 Impact factor: 5.226
Authors: Ellen G Piwoz; Jean H Humphrey; Naume V Tavengwa; Peter J Iliff; Edmore T Marinda; Clare D Zunguza; Kusum J Nathoo; Kuda Mutasa; Lawrence H Moulton; Brian J Ward Journal: Am J Public Health Date: 2007-05-30 Impact factor: 9.308
Authors: G R Kaufmann; P Cunningham; A D Kelleher; J Zaunders; A Carr; J Vizzard; M Law; D A Cooper Journal: J Infect Dis Date: 1998-12 Impact factor: 5.226
Authors: Julianne Meisner; D Allen Roberts; Patricia Rodriguez; Monisha Sharma; Morkor Newman Owiredu; Bertha Gomez; Maeve B de Mello; Alexey Bobrik; Arkadii Vodianyk; Andrew Storey; George Githuka; Thato Chidarikire; Ruanne Barnabas; Shiza Farid; Shaffiq Essajee; Muhammad S Jamil; Rachel Baggaley; Cheryl Johnson; Alison L Drake Journal: J Int AIDS Soc Date: 2021-04 Impact factor: 5.396