In utero and intra-partum HIV-1 transmission and acute HIV-1 infection during pregnancy: Using the BED capture enzyme-immunoassay as a surrogate marker for acute infection

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dc.contributor.authorMarinda E.T.
dc.contributor.authorMoulton L.H.
dc.contributor.authorHumphrey J.H.
dc.contributor.authorHargrove J.W.
dc.contributor.authorNtozini R.
dc.contributor.authorMutasa K.
dc.contributor.authorLevin J.
dc.date.accessioned2011-10-13T16:58:54Z
dc.date.available2011-10-13T16:58:54Z
dc.date.issued2011
dc.description.abstractObjective: The BED assay was developed to estimate the proportion of recent HIV infections in a population. We used the BED assay as a proxy for acute infection to quantify the associated risk of mother-tochild-transmission (MTCT) during pregnancy and delivery. Design A total of 3773 HIV-1 sero-positive women were tested within 96 h of delivery using the BED assay, and CD4 cell count measurements were taken. Mothers were classified according to their likelihood of having recently seroconverted. Methods: The risk of MTCT in utero and intra-partum was assessed comparing different groups defined by BED and CD4 cell count, adjusting for background factors using multinomial logistic models. Results: Compared with women with BED≥0.8/CD4≥350 (typical of HIV-1 chronic patients) there was insufficient evidence to conclude that women presenting with BED<0.8/CD4≥350 (typical of recent infections) were more likely to transmit in utero [adjusted odds ratio (aOR)=1.37, 96% confidence interval (CI) 0.90-2.08, P=0.14], whereas women with BED<0.8/CD4 200-349 (possibly recently infected patients) had a 2.57 (95% CI 1.39-4.77, P-value<0.01) odds of transmitting in utero. Women who had BED<0.8/CD4<200 were most likely to transmit in utero (aOR 3.73, 95% CI 1.27- 10.96, P=0.02). BED and CD4 cell count were not predictive of intra-partum infections. Conclusions: These data provide evidence that in utero transmission of HIV might be higher among women who seroconvert during pregnancy. Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2011; all rights reserved.
dc.description.versionArticle
dc.identifier.citationInternational Journal of Epidemiology
dc.identifier.citation40
dc.identifier.citation4
dc.identifier.citationhttp://www.scopus.com/inward/record.url?eid=2-s2.0-80051943566&partnerID=40&md5=98a263f1e083fdaf5732b20958fb943d
dc.identifier.issn3005771
dc.identifier.other10.1093/ije/dyr055
dc.identifier.urihttp://hdl.handle.net/10019.1/16904
dc.subjectBED
dc.subjectCD4
dc.subjectHIV
dc.subjectIn utero
dc.subjectIntra-partum
dc.subjectSeroconversion
dc.subjectdisease transmission
dc.subjecthealth risk
dc.subjecthuman immunodeficiency virus
dc.subjectimmunoassay
dc.subjectinfectious disease
dc.subjectlogistics
dc.subjectpregnancy
dc.subjectpublic health
dc.subjectsurrogate method
dc.subjectwomens health
dc.subjectarticle
dc.subjectCD4 lymphocyte count
dc.subjectchild
dc.subjectclinical article
dc.subjectdelivery
dc.subjectdisease marker
dc.subjectenzyme immunoassay
dc.subjectfemale
dc.subjecthuman
dc.subjectHuman immunodeficiency virus 1 infection
dc.subjectintrapartum care
dc.subjectmale
dc.subjectpregnancy
dc.subjectpriority journal
dc.subjectschool child
dc.subjectvirus transmission
dc.subjectHuman immunodeficiency virus 1
dc.titleIn utero and intra-partum HIV-1 transmission and acute HIV-1 infection during pregnancy: Using the BED capture enzyme-immunoassay as a surrogate marker for acute infection
dc.typeArticle
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