Transmission of HIV‐1 infections from mothers to infants in Haiti. Impact on childhood mortality and malnutrition

Halsey, N; Boulos, Reginald; Holt, E; Ruff, Andrea; Brutus, J-R; Kissinger, Patricia; Tc, Quinn; Coberly, JS; Adrien, M. L.; Boulos, Carlo; Marzouka, J; Davis, Homer; Auguste, U; Mode, F; Joseph, Francis; Fontaine, MF; Dowell, Scott F.; Etheredge, G.D.; Job, JS

doi:10.1016/0020-7292(91)90706-b

Cited by 7 publications

(8 citation statements)

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“…The sample came from the HIV/AIDS surveillance registry of a state health department, and this study sample of women is representative of the HIV-1-infected pregnant women in this geographically defined population. The other studies that examined the relationship between zidovudine use and HIV-1 transmission have been clinic based 8,9,15,[17][18][19][20] and may not be generalizable to all populations of HIV-1-infected women and their children. However, there are limitations to our study.…”

Section: Discussionmentioning

confidence: 99%

Zidovudine and Perinatal Human Immunodeficiency Virus Type 1 Transmission: A Population-Based Approach

et al. 2002

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ABSTRACT.Objective. This study examined the impact of the full 3-arm zidovudine regimen on the perinatal transmission of human immunodeficiency virus type 1 (HIV-1) using population-based data.Methods. We retrospectively ascertained information on zidovudine prescription and other characteristics of HIV-infected pregnant women and children for birth cohort years 1993, 1995, 1996, and 1997 using HIV/ acquired immunodeficiency syndrome registry data from a state health department supplemented by medical record reviews.Results. The transmission rate decreased from 12.5% in 1993 to 4.6% in 1997. The proportions of HIV-1-infected mothers and children who were prescribed all 3 arms of zidovudine increased from 68% in 1995 to 93% in 1997. T he connection between human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in children and mothers with AIDS or at risk for HIV was recognized in the early 1980s. 1 Since then, the number of AIDS cases among children has increased dramatically, and Ͼ90% of these cases among children have been acquired perinatally. 2 The transmission of HIV from mother to child has been estimated to occur in approximately 15% to 30% of children born to HIVinfected women in the United States. 1 Zidovudine is the first antiretroviral medication approved worldwide for the treatment of HIV/ AIDS. It is also the first drug to be used in a clinical trial of HIV-infected pregnant women to determine its efficacy in reducing perinatal HIV transmission. 3 This randomized trial-AIDS Clinical Trial Group 076 (ACTG 076)-demonstrated a reduction of perinatal HIV transmission with zidovudine by almost 70%. 3 Since the successful use of zidovudine in HIVinfected pregnant women in the ACTG 076, recommendations have been published for the use of zidovudine to reduce perinatal HIV infection. 4 In addition, other studies have demonstrated the success of zidovudine in reducing perinatal HIV transmission. 5-10 The US and European epidemiologic studies demonstrating striking decreases in the perinatal transmission of HIV from prophylactic (zidovudine) administration have used data from hospitals, public health clinics, and private physicians' offices. This study uses data from a population-based HIV/AIDS surveillance database from a state that has HIV infection reporting by name. The objective of this study was to explore the relationship between zidovudine prescription and perinatal HIV-1 transmission among mother-child pairs in which the mother is known before delivery to be infected with HIV. METHODSData were provided by the state health department for all mother-child pairs who had been reported to the HIV/AIDS surveillance registry, a population-based registry that contains all of the reported HIV-positive or AIDS cases in the state, for calendar years 1993, 1995, 1996, and 1997. Eligible cases included mother-child pairs in which the mother's first confirmed HIV-positive test preceded the birth of the child, prenatal care and delivery occurred in the state, and birth outcome resulted in a live...

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Section: Discussionmentioning

confidence: 99%

Zidovudine and Perinatal Human Immunodeficiency Virus Type 1 Transmission: A Population-Based Approach

et al. 2002

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“…The observed rate of vertical transmission has varied widely among prospective studies conducted in the United States, Europe, Africa, and Haiti (Table 2) (3,10,50,55,62,74,76,108,143). Not only have rates varied considerably among different locations, but longitudinal studies conducted by the same investigators in the same populations have, in general, reported declining vertical transmission rates over time (50, 51).…”

Section: Vertical Transmission Of Hivmentioning

confidence: 99%

“…However, the findings have not been consistent and appear to be related to the severity of maternal HIV disease. In Haiti, children born to HIV seropositive mothers were significantly more likely to be premature, of low birth weight, and malnourished at three and six months of age than were infants born to HIV negative women (62). In Nairobi (17), the mean birth weight of singleton neonates of HIV positive women was significantly lower than that of controls (3090 vs. 3220 g, P = 0.005), and birth weight was < 2500 g in 9% of cases and 3% of controls [odds ratio (OR) 3.0, p. = 0.007].…”

Section: Hiv Infection and Pregnancymentioning

confidence: 99%

HIV Infection and AIDS in Children

Quinn¹,

Ruff

Modlin

1992

Annu. Rev. Public Health

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“…Low birth weight as a result of intrauterine growth retardation is associated with high perinatal mortality, morbidity, and neurodevelopmental disorders (1) and is a common feature among the infants of HIV-infected mothers (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Emerging evidence indicates that both infected and uninfected infants of HIV-positive mothers can be developmentally compromised, suggesting a direct effect of maternal HIV infection (9)(10)(11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

“…Emerging evidence indicates that both infected and uninfected infants of HIV-positive mothers can be developmentally compromised, suggesting a direct effect of maternal HIV infection (9)(10)(11)(12)(13)(14)(15). In several studies, either from populations in which drug use is not common or excluding data from mothers with known drug use, both HIV-infected and uninfected infants of HIV-positive mothers weighed significantly less at birth than the infants of uninfected mothers (9)(10)(11)(12)(13)(14). In addition, a recent proton magnetic resonance spectroscopy study demonstrated central nervous system abnormalities in all infants born to HIV-infected mothers compared with control infants (15).…”

Section: Introductionmentioning

confidence: 99%

Inhibition of murine embryonic growth by human immunodeficiency virus envelope protein and its prevention by vasoactive intestinal peptide and activity-dependent neurotrophic factor.

Dibbern¹,

Glazner²,

Gozes³

et al. 1997

J. Clin. Invest.

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Intrauterine growth retardation and neurodevelopmental handicaps are common among infants born to HIV-positive mothers and may be due to the actions of virions and/or maternally derived viral products. The viral envelope protein, gp120, is toxic to neurons, induces neuronal dystrophy, and retards behavioral development in neonatal rats. Vasoactive intestinal peptide, a neuropeptide regulator of early postimplantation embryonic growth, and the neuroprotective protein, activity-dependent neurotrophic factor, prevent gp120-induced neurotoxicity. Whole embryo culture of gestational day 9.5 mouse embryos was used to assess the effect of gp120 on growth. Embryos treated with gp120 exhibited a dose-dependent inhibition of growth. gp120-treated embryos (10 Ϫ 8 M) grew 1.2 somites in the 6-h incubation period, compared with 3.9 somites by control embryos. Embryos treated with gp120 were significantly smaller in cross-sectional area and had significantly less DNA and protein than controls. Growth inhibition induced by gp120 was prevented by cotreatment with vasoactive intestinal peptide or activity-dependent neurotrophic factor. gp120 may play a role in the growth retardation and developmental delays experienced by infants born to HIV-positive mothers.

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Transmission of HIV‐1 infections from mothers to infants in Haiti. Impact on childhood mortality and malnutrition

Abstract: Of 4588 pregnant women in a high-risk Haitian population, 443

Cited by 7 publications

References 0 publications

Zidovudine and Perinatal Human Immunodeficiency Virus Type 1 Transmission: A Population-Based Approach

Zidovudine and Perinatal Human Immunodeficiency Virus Type 1 Transmission: A Population-Based Approach

HIV Infection and AIDS in Children

Inhibition of murine embryonic growth by human immunodeficiency virus envelope protein and its prevention by vasoactive intestinal peptide and activity-dependent neurotrophic factor.

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