Abstract | BACKGROUND: Little is known about the impact of HIV-1 group M subtypes on mother-to-child transmission (MTCT) of HIV-1 in African settings where multiple HIV-1 group M subtypes are co-circulating. OBJECTIVE: To assess the role of subtype variation on MTCT. METHODS: HIV-1-infected women attending an antenatal clinic in western Kenya were enrolled for a prospective study (1996-2000) of MTCT. HIV-1 subtype analysis of p24gag and gp41env identified potential recombinants, and their role in MTCT was determined. RESULTS: Among 414 women for whom HIV-1 subtype and HIV transmission status were available, MTCT occurred in 80 (19.3%). MTCT rates were higher among women with subtype D compared with subtype A in either the gp41 region [31.6 versus 16.1%, relative risk (RR) 2.0, P=0.002] or p24 region (29.9 versus 18.0%, RR 1.7, P=0.02). Discordant subtype combinations were identified in 103 of the women (25.9%), and were associated with higher rates of MTCT (28.2 versus 17.0%, RR 1.7, P=0.01). In multivariate analysis, women with subtype combinations D/D, D/A, and A/D had an increased risk of MTCT (adjusted odds ratios 3.5, 2.5, 6.2; P=0.005, 0.05, and 0.0003, respectively) compared with A/A women after adjustment for maternal HIV viral load, placental malaria infection, episiotomy or perineal tear, and low birthweight. CONCLUSION: MTCT appears to be more common among mothers infected with subtype D compared with subtype A. Such differences in MTCT frequency may be caused by altered cellular tropism for placental cell types.
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Authors | Chunfu Yang, Ming Li, Robert D Newman, Ya-Ping Shi, John Ayisi, Anna M van Eijk, Juliana Otieno, Ambrose O Misore, Richard W Steketee, Bernard L Nahlen, Renu B Lal |
Journal | AIDS (London, England)
(AIDS)
Vol. 17
Issue 11
Pg. 1667-74
(Jul 25 2003)
ISSN: 0269-9370 [Print] England |
PMID | 12853749
(Publication Type: Journal Article)
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Chemical References |
- HIV Core Protein p24
- HIV Envelope Protein gp41
- RNA, Viral
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Topics |
- Female
- HIV Core Protein p24
(genetics)
- HIV Envelope Protein gp41
(genetics)
- HIV Infections
(transmission, virology)
- HIV-1
(classification, genetics)
- Humans
- Infectious Disease Transmission, Vertical
- Kenya
- Logistic Models
- Mutation
- Pregnancy
- Pregnancy Complications, Infectious
(virology)
- Prospective Studies
- RNA, Viral
(analysis)
- Risk Factors
- Viral Load
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