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1994-08-27
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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).