摘要:

ObjectiveTo examine predictors of vertical transmission of HIV-1 in Dar-es-Salaam, Tanzania.DesignObservational design.MethodsConsenting HIV-1-infected pregnant women (n = 1078) were enrolled in a trial to examine the role of vitamin supplements. Intrauterine HIV-1 infection (HIV-positive at birth); intrapartum and early breastfeeding transmission (HIV-positive at 6 weeks among those uninfected at birth) were defined using the PCR.ResultsOf 734 infants who had a specimen taken at birth, 62 were HIV positive [8.4%; 95% confidence interval (CI),6.4–10.5%], whereas 59 infants were positive among 367 infants who were uninfected at birth and were retested at 6 weeks (16.1%; 95%CI, 12.3–19.8%). In multivariate analyses, maternal CD4 cell count, viral load, and clinical stage were significant predictors of both definitions of transmission. Viral load of 50 000 copies/ml or more at delivery was associated with a 4.21-fold increase in risk of intrapartum and early breastfeeding transmission (95%CI, 1.59–11.13;P =0.004). Babies who were HIV negative at birth and born before 34 weeks of gestation were 2.19 times more likely to become infected during intrapartum and early breastfeeding periods compared with those born after 37 weeks (95%CI, 1.19–4.04;P =0.01). Gonorrhea at baseline was related to intrauterine transmission [multivariate risk ratio (RR), 5.50; 95%CI, 2.04–14.81;P< 0.001] but not intrapartum and early breastfeeding transmission. Signs of lower genital infections at or after enrollment were also associated with transmission.ConclusionsReducing prematurity, rate of HIV disease progression, and maternal viral load at or after delivery could help to reduce vertical transmission. Treatment of sexually transmitted infections at onset of prenatal care, about 20 weeks on average, was inadequate for prevention of transmission. Whether sustained clearance of lower genital tract infections result in reduced transmission remains to be determined.

ISSN:0269-9370    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo estimate the seroprevalence of HHV-8 in several Spanish subpopulations with different risk levels of acquiring HIV-1 infection and from different geographical regions.DesignCross-sectional seroprevalence study.MethodsA total of 1699 serum samples from blood donors (613), children under the age of 12 years (100), injecting drug users (IDU) (382), heterosexuals attending a sexually transmitted disease (STD) clinic (273) and homosexual men attending a STD clinic or a HIV-based hospital unit (331) were analysed for anti-HHV-8 antibodies. The presence of antibodies against HHV-8 was tested with an indirect immunofluorescence assay (IFA). A subsample of HHV-8-positive samples was also tested for antibody titre against HHV-8.ResultsThe overall seroprevalence of antibodies against HHV-8 for the blood donor population was 6.5% (7.0% in Andalusia, 8.0% in Catalonia and 4.5% in the Basque Country). None of the children tested positive for HHV-8. The HHV-8 prevalence was 86.7% in HIV-positive homosexual men and 28.0% in HIV-negative homosexual men (P< 0.001). Of heterosexual men attending STD clinics, 17.2% tested positive for HHV-8; 11.5% of IDU tested positive for HHV-8. HHV-8 antibody titres by groups parallel the distribution of HHV-8 prevalence. No association between HHV-8 antibody titres and CD4 cell count or HIV viral load was identified.ConclusionsThe HHV-8 prevalence among blood donors in Spain is higher than in Northern Europe and the USA, but is similar to that in Northern Italy. The distribution of HHV-8 is compatible with a sexually transmitted agent. The distribution of HHV-8 correlates with that of Kaposi's sarcoma but factors other than HHV-8 seem to explain the Kaposi sarcoma distribution.

ISSN:0269-9370    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:2001

数据来源: OVID