Placental Malaria and Mother-to-Child Transmission of Human Immunodeficiency Virus-1 in Rural Rwanda

Bulterys, Philip L.; Chao, Ann; Dalai, Sudeb C.; Zink, M. Christine; Dushimimana, Abel; Katzenstein, David; Saah, Alfred J.; Bulterys, Marc

doi:10.4269/ajtmh.2011.10-0589

Cited by 21 publications

(10 citation statements)

References 29 publications

(43 reference statements)

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“…Our finding of a statistically significant positive association between MIP and MTCT is corroborated by findings of a twofold higher risk of HIV MTCT among HIV‐positive mothers with MIP in the Rakai District of Uganda and the recently reported sixfold elevated odds of early HIV MTCT for infants of Rwandan HIV‐positive women with MIP . Our results are further supported by the finding of a higher risk of MTCT among HIV‐positive pregnant women with high‐density placental malaria in western Kenya and the recent finding of a MIP associated increased risk of HIV MTCT by Msamanga et al .…”

Section: Discussioncontrasting

confidence: 99%

“…Nevertheless, there is little research on the potential contribution of coincident infections, such as malaria in pregnancy (MIP), to early HIV MTCT among HIV-exposed infants of HIV-infected women in SSA; when available, results have been inconclusive [6][7][8][10][11][12][13][14][15][16]. In a short-term prospective study of infants born to 277 HIV-positive Kenyan women and 372 HIV-negative hospital-based controls, Inion et al found no association between placental malaria and in utero or peripartal transmission of HIV-1 by 6 weeks [13].…”

Section: Introductionmentioning

confidence: 99%

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Clinical malaria diagnosis in pregnancy in relation to early perinatal mother‐to‐child transmission of HIV: a prospective cohort study

et al. 2013

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Objectives We prospectively investigated fever symptoms and maternal diagnosis of malaria in pregnancy (MIP) in relation to child HIV infection among 2,368 pregnant HIV-positive women and their infants, followed-up from pregnancy until birth and 6 weeks post-delivery in Tanzania. Methods Doctors clinically diagnosed and treated MIP and fever symptoms during prenatal healthcare. Child HIV status was determined via DNA-PCR. Multivariable logistic regression models estimated relative risks (RR) and 95% confidence intervals (CI) for HIV mother-to-child-transmission (MTCT) by 6th week of life. Results Mean gestational age at enrollment was 22.2 weeks. During follow-up, 16.6% had ≥1 MIP diagnosis, 15.9% reported fever symptoms and 8.7% had both fever and MIP diagnosis. Eleven percent of HIV-exposed infants were HIV-positive by 6 weeks. The RR of HIV MTCT was statistically similar for infants whose mothers were ever vs. never clinical MIP diagnosed (RR=1.24, 95%CI:0.94–1.64), were diagnosed with 1 vs. 0 clinical MIP episode (RR=1.07;95%CI:0.77–1.48) and had ever vs. never reported fever symptoms (RR=1.04, 95%CI:0.78,1.38) in pregnancy. However, HIV MTCT risk increased by 29% (95%CI:4–58%) per MIP episode. Infants of women with ≥2 vs. 0 MIP diagnoses were 2.1 times more likely to be HIV infected by 6weeks old (95%CI:1.31–3.45). Conclusions Clinical MIP diagnosis, but not fevers, in HIV-positive pregnant women was associated with elevated risk of early HIV MTCT suggesting that malaria prevention and treatment in pregnant HIV-positive women may enhance the effectiveness of HIV prevention in MTCT programs in this setting. Future studies using laboratory confirmed malaria is needed to confirm this association.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical malaria diagnosis in pregnancy in relation to early perinatal mother‐to‐child transmission of HIV: a prospective cohort study

et al. 2013

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“…Early work suggested that the combination of PM and maternal HIV was associated with increased infant mortality relative to HIV infection alone but did not specifically examine the HIV status of the offspring . PM as a specific risk factor for mother to child transmission (MTCT) of HIV, after adjustment for HIV viral load, has subsequently been confirmed . Not all studies, however, support this conclusion.…”

Section: Maternal Malaria Predicts An Increased Risk Of Nonmalarial Amentioning

confidence: 99%

Malaria in pregnancy shapes the development of foetal and infant immunity

Harrington

Kakuru

Jagannathan

2018

Parasite Immunology

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Malaria, particularly Plasmodium falciparum, continues to disproportionately affect pregnant women. In addition to the profoundly deleterious impact of maternal malaria on the health of the mother and foetus, malaria infection in pregnancy has been shown to affect the development of the foetal and infant immune system and may alter the risk of malaria and nonmalarial outcomes during infancy. This review summarizes our current understanding of how malaria infection in pregnancy shapes the protective components of the maternal immune system transferred to the foetus and how foetal exposure to parasite antigens impacts the development of foetal and infant immunity. It also reviews existing evidence linking malaria infection in pregnancy to malaria and nonmalarial outcomes in infancy and how preventing malaria in pregnancy may alter these outcomes. A better understanding of the consequences of malaria infection in pregnancy on the development of foetal and infant immunity will inform control strategies, including intermittent preventive treatment in pregnancy and vaccine development.

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“…Antibiotic therapy of infections such as typhoid fever and listeriosis might have to be extended beyond the 2 weeks recommended for non-pregnant individuals especially if infection occurs during the first trimester. 22,23 …”

Section: Looking Aheadmentioning

confidence: 99%

Intracellular Organisms as Placental Invaders

Vigliani

Bakardjiev

2014

Fet. Matern. Med. Rev.

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In this article we present a novel model for how the human placenta might get infected via the hematogenous route. We present a list of diverse placental pathogens, like Listeria monocytogenes or Cytomegalovirus, which are familiar to most obstetricians, but others, like Salmonella typhi, have only been reported in case studies or small case series. Remarkably, all of these organisms on this list are either obligate or facultative intracellular organisms. These pathogens are able to enter and survive inside host immune cells for at least a portion of their life cycle. We suggest that many blood-borne pathogens might arrive at the placenta via transportation inside of maternal leukocytes that enter the decidua in early pregnancy. We discuss mechanisms by which extravillous trophoblasts could get infected in the decidua and spread infection to other layers in the placenta. We hope to raise awareness among OB/GYN clinicians that organisms not typically associated with the TORCH list might cause placental infections and pregnancy complications.

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Placental Malaria and Mother-to-Child Transmission of Human Immunodeficiency Virus-1 in Rural Rwanda

Cited by 21 publications

References 29 publications

Clinical malaria diagnosis in pregnancy in relation to early perinatal mother‐to‐child transmission of HIV: a prospective cohort study

Clinical malaria diagnosis in pregnancy in relation to early perinatal mother‐to‐child transmission of HIV: a prospective cohort study

Malaria in pregnancy shapes the development of foetal and infant immunity

Intracellular Organisms as Placental Invaders

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