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COMBINED EVALUATION OF SEXUALLY TRANSMITTED INFECTIONS IN HIV-INFECTED PREGNANT WOMEN AND INFANT HIV TRANSMISSION
Adachi, Kristina et al. | Date Issued: 2018
Author
Adachi, Kristina
Xu, Jiahong
Yeganeh, Nava
Camarca, Margaret
Morgado, Mariza G.
Watts, D. Heather
Mofenson, Lynne M.
Veloso, Valdiléa G.
Pilotto, José Henrique
Joao, Esau
Gray, Glenda
Theron, Gerhard
Santos, Breno
Fonseca, Rosana
Kreitchmann, Regis
Pinto, Jorge
Mussi-Pinhata, Marisa M.
Ceriotto, Mariana
Machado, Daisy Maria
Bryson, Yvonne J.
Grinsztejn, Beatriz
Moye, Jack
Klausner, Jeffrey D.
Bristow, Claire C.
Dickover, Ruth
Mirochnick, Mark
Nielsen-Saines, Karin
Affilliation
David Geffen UCLA School of Medicine. Los Angeles, CA, United States of America.
Westat. Rockville, MD, United States of America.
David Geffen UCLA School of Medicine. Los Angeles, CA, United States of America.
Westat. Rockville, MD, United States of America.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil.
Office of the Global AIDS Coordinator, U.S. Department of State. Washington D.C., United States of America.
Elizabeth Glaser Pediatric AIDS Foundation. Washington D.C., United States of America.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ. Brasil
Hospital Geral de Nova Iguaçu. Nova Iguaçu, RJ, Brazil.
Hospital Federal dos Servidores do Estado. Rio de Janeiro, RJ, Brazil.
SAMRC and Perinatal HIV Research Unit. University of Witwatersrand, Johannesburg, South Africa.
Stellenbosch University/Tygerberg Hospital. Cape Town, South Africa.
Hospital Conceicao. Porto Alegre, RS, Brazil.
Hospital Femina. Porto Alegre, RS, Brazil.
Irmandade da Santa Casa de Misericordia de Porto Alegre. Porto Alegre, RS, Brazil.
Federal University of Minas Gerais. Belo Horizonte, MG, Brazil.
University of São Paulo. Ribeirão Preto Medical School. São Paulo, SP, Brazil.
Foundation for Maternal and Infant Health. Buenos Aires, Argentina.
Escola Paulista de Medicina-Universidade Federal de São Paulo. São Paulo, SP, Brazil.
David Geffen UCLA School of Medicine. Los Angeles, CA, United States of America.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Departamento de Doenças Infecciosas. Rio de Janeiro, RJ. Brasil.
Eunice Kennedy Shriver National Institute of Child Health and Human Development. National Institutes of Health. Bethesda, MD, United States of America.
David Geffen UCLA School of Medicine. Los Angeles, CA, United States of America / UCLA Fielding School of Public Health, Los Angeles, CA, United States of America.
UCSD School of Medicine. La Jolla, CA, United States of America.
UC Davis School of Medicine. Davis, CA, United States of America.
Boston University School of Medicine. Boston, MA, United States of America.
David Geffen UCLA School of Medicine, Los Angeles, CA, United States of America.
Abstract
BACKGROUND: Sexually transmitted infections (STIs) including Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Treponema pallidum (TP), and cytomegalovirus (CMV) may lead to adverse pregnancy and infant outcomes. The role of combined maternal STIs in HIV mother-to-child transmission (MTCT) was evaluated in mother-infant pairs from NICHD HPTN 040. METHODOLOGY: Urine samples from HIV-infected pregnant women during labor were tested by polymerase chain reaction (PCR) for CT, NG, and CMV. Infant HIV infection was determined by serial HIV DNA PCR testing. Maternal syphilis was tested by VDRL and confirmatory treponemal antibodies. RESULTS: A total of 899 mother-infant pairs were evaluated. Over 30% had at least one of the following infections (TP, CT, NG, and/or CMV) detected at the time of delivery. High rates of TP (8.7%), CT (17.8%), NG (4%), and CMV (6.3%) were observed. HIV MTCT was 9.1% (n = 82 infants). HIV MTCT was 12.5%, 10.3%, 11.1%, and 26.3% among infants born to women with CT, TP, NG or CMV respectively. Forty-two percent of HIV-infected infants were born to women with at least one of these 4 infections. Women with these infections were nearly twice as likely to have an HIV-infected infant (aOR 1.9, 95% CI 1.1-3.0), particularly those with 2 STIs (aOR 3.4, 95% CI 1.5-7.7). Individually, maternal CMV (aOR 4.4 1.5-13.0) and infant congenital CMV (OR 4.1, 95% CI 2.2-7.8) but not other STIs (TP, CT, or NG) were associated with an increased risk of HIV MTCT. CONCLUSION: HIV-infected pregnant women identified during labor are at high risk for STIs. Co-infection with STIs including CMV nearly doubles HIV MTCT risk. CMV infection appears to confer the largest risk of HIV MTCT.
Keywords in Portuguese
HIV
Citomegalovírus
Gravidez
Doenças Sexualmente Transmissíveis
Bebê
 
Keywords
HIV
Cytomegalovirus Infection
Sexually Transmitted Infections
HIV-infected pregnancy
Infants
Sexually Transmitted Diseases
 
Publisher
Public Library of Science
Citation
ADACHI, Kristina etal. Combined evaluation of sexually transmitted infections in HIV-infected pregnant women and infant HIV transmission. Plos One, v 13, n 1, 05 Jan 2018.
DOI
10.1371/journal.pone.0189851