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Risk factors for in utero or intrapartum mother-to-child transmission of human immunodeficiency virus type 1 in Thailand.
J Infect Dis. 2007 Dec 01; 196(11):1629-36.JI

Abstract

BACKGROUND

The identification of risk factors for in utero and intrapartum transmission of human immunodeficiency virus type 1 (HIV-1) is crucial to the design and understanding of preventive interventions.

METHODS

The randomized Perinatal HIV Prevention Trial-1 enrolled 1437 pregnant women and their non-breast-fed infants, to compare the efficacy of various durations of zidovudine prophylaxis. Using univariate and multivariate logistic regression analyses, we studied the role that factors known or occurring at various times during gestation or delivery play in in utero and intrapartum transmission.

RESULTS

Variables independently associated with in utero transmission were HIV-1 load >35,000 copies/mL (adjusted odds ratio [AOR], 4.2) and delayed initiation of maternal zidovudine prophylaxis until >31.4 weeks gestation (AOR, 3.0). Variables associated with intrapartum transmission were HIV-1 load >10,000 copies/mL (AOR, 3.8 for 10,000-35,000 copies/mL and 7.1 for >35,000 copies/mL), induction of labor (AOR, 2.6), and premature labor with tocolysis (AOR, 15.1).

CONCLUSIONS

With the exception of very high HIV-1 load, risk factors for in utero transmission were different from those for intrapartum transmission. Optimal prophylactic interventions must address each of the major risk factors, with appropriate timing.

Authors+Show Affiliations

Institut de Recherche pour le Developpement, UMI 174 "Epidemiologie Clinique, Sante Maternelle et Infantile et Sida", Paris, France. gjourdai@hsph.harvard.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18008246

Citation

Jourdain, Gonzague, et al. "Risk Factors for in Utero or Intrapartum Mother-to-child Transmission of Human Immunodeficiency Virus Type 1 in Thailand." The Journal of Infectious Diseases, vol. 196, no. 11, 2007, pp. 1629-36.
Jourdain G, Mary JY, Coeur SL, et al. Risk factors for in utero or intrapartum mother-to-child transmission of human immunodeficiency virus type 1 in Thailand. J Infect Dis. 2007;196(11):1629-36.
Jourdain, G., Mary, J. Y., Coeur, S. L., Ngo-Giang-Huong, N., Yuthavisuthi, P., Limtrakul, A., Traisathit, P., McIntosh, K., & Lallemant, M. (2007). Risk factors for in utero or intrapartum mother-to-child transmission of human immunodeficiency virus type 1 in Thailand. The Journal of Infectious Diseases, 196(11), 1629-36.
Jourdain G, et al. Risk Factors for in Utero or Intrapartum Mother-to-child Transmission of Human Immunodeficiency Virus Type 1 in Thailand. J Infect Dis. 2007 Dec 1;196(11):1629-36. PubMed PMID: 18008246.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for in utero or intrapartum mother-to-child transmission of human immunodeficiency virus type 1 in Thailand. AU - Jourdain,Gonzague, AU - Mary,Jean-Yves, AU - Coeur,Sophie Le, AU - Ngo-Giang-Huong,Nicole, AU - Yuthavisuthi,Praparb, AU - Limtrakul,Aram, AU - Traisathit,Patrinee, AU - McIntosh,Kenneth, AU - Lallemant,Marc, AU - ,, Y1 - 2007/10/25/ PY - 2007/01/23/received PY - 2007/06/05/accepted PY - 2007/11/17/pubmed PY - 2007/12/29/medline PY - 2007/11/17/entrez SP - 1629 EP - 36 JF - The Journal of infectious diseases JO - J Infect Dis VL - 196 IS - 11 N2 - BACKGROUND: The identification of risk factors for in utero and intrapartum transmission of human immunodeficiency virus type 1 (HIV-1) is crucial to the design and understanding of preventive interventions. METHODS: The randomized Perinatal HIV Prevention Trial-1 enrolled 1437 pregnant women and their non-breast-fed infants, to compare the efficacy of various durations of zidovudine prophylaxis. Using univariate and multivariate logistic regression analyses, we studied the role that factors known or occurring at various times during gestation or delivery play in in utero and intrapartum transmission. RESULTS: Variables independently associated with in utero transmission were HIV-1 load >35,000 copies/mL (adjusted odds ratio [AOR], 4.2) and delayed initiation of maternal zidovudine prophylaxis until >31.4 weeks gestation (AOR, 3.0). Variables associated with intrapartum transmission were HIV-1 load >10,000 copies/mL (AOR, 3.8 for 10,000-35,000 copies/mL and 7.1 for >35,000 copies/mL), induction of labor (AOR, 2.6), and premature labor with tocolysis (AOR, 15.1). CONCLUSIONS: With the exception of very high HIV-1 load, risk factors for in utero transmission were different from those for intrapartum transmission. Optimal prophylactic interventions must address each of the major risk factors, with appropriate timing. SN - 0022-1899 UR - https://www.unboundmedicine.com/medline/citation/18008246/Risk_factors_for_in_utero_or_intrapartum_mother_to_child_transmission_of_human_immunodeficiency_virus_type_1_in_Thailand_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1086/522009 DB - PRIME DP - Unbound Medicine ER -