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participating institutions:
Johns Hopkins University AIDS Service, New York State DOH AIDS Institute, The CORE Center, Cook County Hospital



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Correlates of Mother-to-Child Human Immunodeficiency Virus Type 1 (HIV-1) Transmission: Association with Maternal Plasma HIV-1 RNA Load, Genital HIV-1 DNA Shedding, and Breast Infections [John GC, et al. JID 2001;183:206]: This is a report of a perinatal transmission study from Nairobi, Kenya regarding 279 infants born to HIV-infected women. Analysis of the infants at two years showed 92 had HIV infection and 187 did not. Risks for HIV transmission were a viral load >43,000 (OR 4.0), maternal cervical HIV DNA - OR 2.4, vaginal HIV DNA - OR 2.4, genital ulcer - OR 2.7, breast feeding - OR 1.7, and mastitis - OR 3.9. The authors conclude that methods are needed to decrease infant exposure to HIV in maternal genital and breast secretions.
Comment: All of these observations are consistent with the assumption that inoculum size dictates the probability of infection with HIV as it does with virtually every other infectious disease.
posted 3/29/2001





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