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1996-02-27
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Document 0260
DOCN M9630260
TI Estimated timing of mother-to-child human immunodeficiency virus type 1
(HIV-1) transmission by use of a Markov model. The HIV Infection in
Newborns French Collaborative Study Group.
DT 9603
AU Rouzioux C; Costagliola D; Burgard M; Blanche S; Mayaux MJ; Griscelli C;
Valleron AJ; Laboratoire de Virologie, Hopital Necker-Enfants Malades,
Paris,; France.
SO Am J Epidemiol. 1995 Dec 15;142(12):1330-7. Unique Identifier : AIDSLINE
MED/96108954
AB It has been shown that mother-to-child human immunodeficiency virus type
1 (HIV-1) transmission can occur both during pregnancy and at delivery,
but the respective frequencies in these periods are unknown. Moreover,
it is difficult to determine the timing of mother-to-child HIV-1
transmission by direct sampling. The use of an elaborate statistical
method is therefore necessary. The authors studied 495 consecutive
infants born between May 1988 and August 1991 who were included, at
birth, in the French Prospective Study on Pediatric HIV Infection. At
least one blood sample was obtained from every infant during the first
14 days of life. All samples obtained within 3 months of birth were
tested by at least two of the following methods: viral culture,
polymerase chain reaction (PCR), and antigenemia, as well as by Western
blot test. Data for the 95 infected infants (those seropositive at 18
months and those who died of HIV disease before this age), and who were
exclusively bottle-fed, were analyzed in a Markov model to estimate the
timing of viral transmission, the time from birth to the emergence of
detectable virus, and the time from birth to seroconversion. The model
indicated that one-third of the infants were infected in utero, less
than 2 months before delivery (95th percentile). In the remaining 65% of
cases (95% confidence interval (CI) 22-92), the date of infection was
estimated as the day of birth. The estimated median period between birth
and the emergence of viral markers was 10 days (95% CI 6-14) and the
95th percentile was estimated at 56 days. These results support the view
that HIV infection can be diagnosed during the first 3 months of life.
The authors conclude that mother-to-child HIV-1 transmission appears to
occur late in pregnancy or at delivery.
DE Adult Biological Markers/BLOOD *Disease Transmission,
Vertical/STATISTICS & NUMER DATA Female France Human HIV
Antibodies/BLOOD HIV Infections/BLOOD/*TRANSMISSION *HIV-1/IMMUNOLOGY
Infant, Newborn Markov Chains Polymerase Chain Reaction/STATISTICS &
NUMER DATA Pregnancy Prospective Studies Support, Non-U.S. Gov't
Time Factors JOURNAL ARTICLE MULTICENTER STUDY
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).