Document 0726
 DOCN  M9480726
 TI    Prospective comparison of mother-to-child transmission of HIV-1 and
       HIV-2 in Abidjan, Ivory Coast [see comments]
 DT    9410
 AU    Adjorlolo-Johnson G; De Cock KM; Ekpini E; Vetter KM; Sibailly T;
       Brattegaard K; Yavo D; Doorly R; Whitaker JP; Kestens L; et al; Projet
       RETRO-CI, Abidjan, Ivory Coast.
 SO    JAMA. 1994 Aug 10;272(6):462-6. Unique Identifier : AIDSLINE
       MED/94315725
 CM    Comment in: JAMA 1994 Aug 10;272(6):487-8
 AB    OBJECTIVE--To compare mother-to-child transmission of human
       immunodeficiency virus types 1 and 2 (HIV-1 and HIV-2, respectively) and
       to assess the impact of maternal HIV-1 and HIV-2 infections on child
       survival. DESIGN--Prospective cohort study. SETTING--Maternal and child
       health center in a lower socioeconomic class district of Abidjan, Ivory
       Coast. PARTICIPANTS--A total of 18,099 women delivering between 1990 and
       1992 were tested for HIV-1 and HIV-2 antibodies. A cohort of 613
       pregnant women and their infants was followed prospectively (138 women
       reactive to HIV-1, 132 reactive to HIV-2, 69 reactive to both viruses,
       and 274 HIV-seronegative). MAIN OUTCOME MEASURES--Rates of perinatal
       transmission for HIV-1, HIV-2, and both viruses, determined from results
       of serological and polymerase chain reaction tests on children; survival
       of infants born to HIV-1-positive, HIV-2-positive, dually reactive, and
       HIV-seronegative women. RESULTS--Of the 18,099 women tested, 9.4% were
       reactive to HIV-1 alone, 1.6% to HIV-2 alone, and 1.0% to both viruses.
       The rate of perinatal transmission of HIV-1 was 24.7% (95% confidence
       interval [CI], 15.8% to 33.7%), compared with 1.2% (95% CI, 0.0% to
       3.5%) for HIV-2 (relative risk, 21.3; 95% CI, 2.9 to 154.3). Overall,
       19.0% (95% CI, 9.0% to 29.0%) of infants of dually reactive women became
       infected; of the 11 children concerned, 10 were infected with HIV-1 and
       one with HIV-1 and HIV-2. Infants of HIV-seropositive mothers had a
       reduced survival; mortality rates were 15.1, 13.0, 6.5, and 3.4 deaths
       per 100 child-years, respectively, for children of HIV-1-positive,
       dually reactive, HIV-2-positive, and HIV-seronegative women.
       CONCLUSIONS--The rate of perinatal transmission of HIV-2 (1.2%) was much
       lower than the rate of perinatal transmission of HIV-1 (24.7%), and this
       was associated with more favorable survival for infants of
       HIV-2-infected mothers. Dually reactive women could transmit both
       viruses, although transmission usually involved HIV-1 only. Public
       health guidelines should incorporate advice that perinatal transmission
       of HIV-2 is rare.
 DE    Adolescence  Adult  AIDS Serodiagnosis  Comparative Study  Cote
       d'Ivoire/EPIDEMIOLOGY  Female  Human  HIV
       Infections/*CONGENITAL/IMMUNOLOGY/MORTALITY/*TRANSMISSION  HIV
       Seronegativity/IMMUNOLOGY  HIV
       Seropositivity/DIAGNOSIS/EPIDEMIOLOGY/TRANSMISSION
       *HIV-1/IMMUNOLOGY/ISOLATION & PURIF  *HIV-2/IMMUNOLOGY/ISOLATION & PURIF
       Infant  Polymerase Chain Reaction  Pregnancy  *Pregnancy Complications,
       Infectious/EPIDEMIOLOGY/IMMUNOLOGY  Prevalence  Prospective Studies
       Survival Rate  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).