Combined evaluation of sexually transmitted infections in HIV-infected pregnant women and infant HIV transmission.
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...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2018-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5755782?pdf=render |
| _version_ | 1831527389628203008 |
|---|---|
| author | Kristina Adachi Jiahong Xu Nava Yeganeh Margaret Camarca Mariza G Morgado D Heather Watts Lynne M Mofenson Valdilea G Veloso Jose Henrique Pilotto Esau Joao Glenda Gray Gerhard Theron Breno Santos Rosana Fonseca Regis Kreitchmann Jorge Pinto Marisa M Mussi-Pinhata Mariana Ceriotto Daisy Maria Machado Yvonne J Bryson Beatriz Grinsztejn Jack Moye Jeffrey D Klausner Claire C Bristow Ruth Dickover Mark Mirochnick Karin Nielsen-Saines NICHD HPTN 040 Study Team |
| author_facet | Kristina Adachi Jiahong Xu Nava Yeganeh Margaret Camarca Mariza G Morgado D Heather Watts Lynne M Mofenson Valdilea G Veloso Jose Henrique Pilotto Esau Joao Glenda Gray Gerhard Theron Breno Santos Rosana Fonseca Regis Kreitchmann Jorge Pinto Marisa M Mussi-Pinhata Mariana Ceriotto Daisy Maria Machado Yvonne J Bryson Beatriz Grinsztejn Jack Moye Jeffrey D Klausner Claire C Bristow Ruth Dickover Mark Mirochnick Karin Nielsen-Saines NICHD HPTN 040 Study Team |
| author_sort | Kristina Adachi |
| collection | DOAJ |
| description | 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. TRIAL REGISTRATION:NCT00099359. |
| first_indexed | 2024-12-16T16:28:02Z |
| format | Article |
| id | doaj.art-c219fddeb53d4b9e917faa46a8c7843f |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-16T16:28:02Z |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-c219fddeb53d4b9e917faa46a8c7843f2022-12-21T22:24:40ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01131e018985110.1371/journal.pone.0189851Combined evaluation of sexually transmitted infections in HIV-infected pregnant women and infant HIV transmission.Kristina AdachiJiahong XuNava YeganehMargaret CamarcaMariza G MorgadoD Heather WattsLynne M MofensonValdilea G VelosoJose Henrique PilottoEsau JoaoGlenda GrayGerhard TheronBreno SantosRosana FonsecaRegis KreitchmannJorge PintoMarisa M Mussi-PinhataMariana CeriottoDaisy Maria MachadoYvonne J BrysonBeatriz GrinsztejnJack MoyeJeffrey D KlausnerClaire C BristowRuth DickoverMark MirochnickKarin Nielsen-SainesNICHD HPTN 040 Study TeamBACKGROUND: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. TRIAL REGISTRATION:NCT00099359.http://europepmc.org/articles/PMC5755782?pdf=render |
| spellingShingle | Kristina Adachi Jiahong Xu Nava Yeganeh Margaret Camarca Mariza G Morgado D Heather Watts Lynne M Mofenson Valdilea G Veloso Jose Henrique Pilotto Esau Joao Glenda Gray Gerhard Theron Breno Santos Rosana Fonseca Regis Kreitchmann Jorge Pinto Marisa M Mussi-Pinhata Mariana Ceriotto Daisy Maria Machado Yvonne J Bryson Beatriz Grinsztejn Jack Moye Jeffrey D Klausner Claire C Bristow Ruth Dickover Mark Mirochnick Karin Nielsen-Saines NICHD HPTN 040 Study Team Combined evaluation of sexually transmitted infections in HIV-infected pregnant women and infant HIV transmission. PLoS ONE |
| title | Combined evaluation of sexually transmitted infections in HIV-infected pregnant women and infant HIV transmission. |
| title_full | Combined evaluation of sexually transmitted infections in HIV-infected pregnant women and infant HIV transmission. |
| title_fullStr | Combined evaluation of sexually transmitted infections in HIV-infected pregnant women and infant HIV transmission. |
| title_full_unstemmed | Combined evaluation of sexually transmitted infections in HIV-infected pregnant women and infant HIV transmission. |
| title_short | Combined evaluation of sexually transmitted infections in HIV-infected pregnant women and infant HIV transmission. |
| title_sort | combined evaluation of sexually transmitted infections in hiv infected pregnant women and infant hiv transmission |
| url | http://europepmc.org/articles/PMC5755782?pdf=render |
| work_keys_str_mv | AT kristinaadachi combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT jiahongxu combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT navayeganeh combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT margaretcamarca combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT marizagmorgado combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT dheatherwatts combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT lynnemmofenson combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT valdileagveloso combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT josehenriquepilotto combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT esaujoao combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT glendagray combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT gerhardtheron combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT brenosantos combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT rosanafonseca combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT regiskreitchmann combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT jorgepinto combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT marisammussipinhata combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT marianaceriotto combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT daisymariamachado combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT yvonnejbryson combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT beatrizgrinsztejn combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT jackmoye combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT jeffreydklausner combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT clairecbristow combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT ruthdickover combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT markmirochnick combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT karinnielsensaines combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission AT nichdhptn040studyteam combinedevaluationofsexuallytransmittedinfectionsinhivinfectedpregnantwomenandinfanthivtransmission |