Risk factors of HIV vertical transmission in a cohort of women under a PMTCT program at three peri-urban clinics in a resource-poor setting

Gumbo, Felicity Zvanyadza; Duri, Kerina; Kandawasvika, Gwendoline; Kurewa, Nyaradzai Edith; Mapingure, Munyaradzi; Munjoma, Marshall; Rusakaniko, S; Chirenje, Mike; Stray‐Pedersen, Babill

doi:10.1038/jp.2010.31

Cited by 32 publications

(27 citation statements)

References 16 publications

(17 reference statements)

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“…However, studies have been done which have found HIV in cells found in electively aborted foetuses in the first trimester of pregnancy (Lewis, et al, 1990). Factors that are associated with transmission during pregnancy are: maternal genital infections, as well as malaria, which can damage the placenta and allow passage of HIV cells (Gumbo et al, 2010;ter Kuile, et al, 2004;Bloland, et al, 1995;Inion, et al, 2003);and, gender, where female infants are thought to be at double the risk of infection than males (Biggar, et al, 2006).…”

Section: Mother-to-child Transmission Of Hiv (Mtct)mentioning

confidence: 99%

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Developmental delay in HIV-exposed infants in Harare, Zimbabwe

Hutchings¹,

Potterton

2013

Vulnerable Children and Youth Studies

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The aim of this cross-sectional study was to determine the difference in development (cognition; receptive and expressive language; and fine and gross motor) of Human Immunodeficiency Virus (HIV) -exposed infected (HEI) infants with the development of HIV-exposed but uninfected (HEU) infants using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). Sixty infants were enrolled in the study; 32 (53.33%) HEU infants and 28 (46.67%) HEI infants. The two groups were well-matched for infant demographics, anthropometry at birth, maternal demographics, as well as socioeconomic status. Statistically significant differences were found in anthropometry and development between the HEI and HEU group. The HEI infants had malnutrition, were stunted and had smaller head circumferences than HEU infants. The BSID-III showed that the mean developmental delay for the HEI group was approximately two months below their mean chronological age for all scales (cognitive; receptive and expressive communication; and, fine and gross motor age).The HEI group showed that 64.29% had cognitive delay, 60.71% had language delay and 53.57% had motor delay, all of which was significantly different from the development of the HEU group for all domains (p<0.001). In addition to using the BSID-III, the majority of mothers were able to correctly indicate whether their child was developing at the same, or at a slower rate of development than children of the same age. This study demonstrates that infants who are HIV-exposed and infected are at risk of developmental delay.

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Section: Mother-to-child Transmission Of Hiv (Mtct)mentioning

confidence: 99%

“…Factors associated with transmission are: early mixed-feeding i.e. before six months of age when the infant's gastrointestinal tract is still immature and susceptible to damage (Coovardia, et al, 2007), abrupt breastfeeding cessation (WHO, 2010b), and mastitis or breast abscess (Gumbo, et al, 2010).…”

Section: Mother-to-child Transmission Of Hiv (Mtct)mentioning

confidence: 99%

Developmental delay in HIV-exposed infants in Harare, Zimbabwe

Hutchings¹,

Potterton

2013

Vulnerable Children and Youth Studies

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“…HIV-1-positive mother and infant pairs were offered 200 mg of single dose nevirapine during labor and 2 mg/kg body weight within 72 h postdelivery, respectively. 18 Mothers were encouraged to exclusively breastfeed during the first 6 months. Infants' venous EDTA whole blood and plasma samples were collected at delivery, at 6 weeks, and at 4 and 9 months postpartum, and thereafter every 3 months until 2 years, thus generally coinciding with infant immunization visits.…”

Section: Study Population and Proceduresmentioning

confidence: 99%

“…EDTA-anticoagulated venous blood samples were processed within 6 h for full blood counts using the Abbott Diagnostic Cell Dyne 3500R SL Hematology Analyser. Mothers were screened for sexually transmitted infections as previously described by Gumbo et al 18 …”

Section: Mothers' Testsmentioning

confidence: 99%

Genotypic Analysis of Human Immunodeficiency Virus Type 1envV3 Loop Sequences: Bioinformatics Prediction of Coreceptor Usage Among 28 Infected Mother–Infant Pairs in a Drug-Naive Population

Duri

Soko²,

Gumbo³

et al. 2011

AIDS Research and Human Retroviruses

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We sought to predict virus coreceptor utilization using a simple bioinformatics method based on genotypic analysis of human immunodeficiency virus types 1 (HIV-1) env V3 loop sequences of 28 infected but drug-naive women during pregnancy and their infected infants and to better understand coreceptor usage in vertical transmission dynamics. The HIV-1 env V3 loop was sequenced from plasma samples and analyzed for viral coreceptor usage and subtype in a cohort of HIV-1-infected pregnant women. Predicted maternal frequencies of the X4, R5X4, and R5 genotypes were 7%, 11%, and 82%, respectively. Antenatal plasma viral load was higher, with a mean log(10) (SD) of 4.8 (1.6) and 3.6 (1.2) for women with the X4 and R5 genotypes, respectively, p = 0.078. Amino acid substitution from the conserved V3 loop crown motif GPGQ to GPGR and lymphadenopathy were associated with the X4 genotype, p = 0.031 and 0.043, respectively. The maternal viral coreceptor genotype was generally preserved in vertical transmission and was predictive of the newborn's viral genotype. Infants born to mothers with X4 genotypes were more likely to have lower birth weights relative to those born to mothers with the R5 genotype, with a mean weight (SD) of 2870 (±332) and 3069 (±300) g, respectively. These data show that at least in HIV-1 subtype C, R5 coreceptor usage is the most predominant genotype, which is generally preserved following vertical transmission and is associated with the V3 GPGQ crown motif. Therefore, antiretroviral-naive pregnant women and their infants can benefit from ARV combination therapies that include R5 entry inhibitors following prediction of their coreceptor genotype using simple bioinformatics methods.

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“…30,34,35 Furthermore, maternal T vaginalis infection in an HIV-infected woman nearly doubles the risk of vertical transmission of HIV to the infant. 36 Interestingly, HIV-infected women are less likely to shed HIV vaginally after receiving treatment for trichomoniasis. 37,38 However, there are no data to show that treating T vaginalis can reverse the increased risks of HIV acquisition or transmission.…”

Section: Adverse Outcomesmentioning

confidence: 99%

Trichomoniasis

Meites

2013

Infectious Disease Clinics of North America

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Risk factors of HIV vertical transmission in a cohort of women under a PMTCT program at three peri-urban clinics in a resource-poor setting

Cited by 32 publications

References 16 publications

Developmental delay in HIV-exposed infants in Harare, Zimbabwe

Developmental delay in HIV-exposed infants in Harare, Zimbabwe

Genotypic Analysis of Human Immunodeficiency Virus Type 1envV3 Loop Sequences: Bioinformatics Prediction of Coreceptor Usage Among 28 Infected Mother–Infant Pairs in a Drug-Naive Population

Trichomoniasis

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