Steketee R, Nahlen B, Ayisi J, Van Eijk A, Otieno J, Misore A, Rayfield M, Udhayakumar K; International Conference on AIDS.
Int Conf AIDS. 1998; 12: 394 (abstract no. 461/23268).
CDC Atlanta, Georgia 30333, USA.
BACKGROUND: Malaria and HIV-1 are common infections in reproductive-age women in sub-Saharan Africa. In Malawi, infants born to HIV(+) women with placental malaria infection had a 3.4-fold increased risk of post-neonatal death compared with infants born to HIV(+) women without placental parasitemia, suggesting that placental malaria infection may promote mother-to-infant HIV transmission. In August 1996 we began a prospective study to assess this possible interaction in western Kenya. METHODS: Between August 1996 and September 1997, consecutive pregnant women attending an antenatal clinic in Kisumu, Kenya, were counseled and offered HIV testing (CT). At delivery placental blood smears were examined for malaria parasitemia, and infants born by spontaneous vaginal delivery to asymptomatic HIV(+) mothers were enrolled into the study. Infants were seen monthly for a clinical exam, or more frequently for intercurrent illness. Infant HIV DNA-PCR was drawn at 2, 3, and 6 months. RESULTS: Among 2976 pregnant women who received CT, 790 (26.5%) were HIV(+). Overall, 18.2% (277/1521) of women had placental malaria infection, and HIV(+) women had higher rates of placental malaria than HIV(-) women (OR 2.06, 95% CI 1.55-2.73). Preliminary results of the 365 infants with follow-up indicate that infants born to HIV(+) mothers with placental malaria infection are more likely to be PCR(+) within the first 3 months of life compared with infants born to mothers without placental parasitemia, although the difference in HIV transmission rates does not yet attain statistical significance. CONCLUSIONS: HIV-1 and malaria are common in pregnant Kenyan women. Preliminary results indicate that HIV(+) women are at increased risk for malaria, and placental malaria may infant HIV transmission. A safe, cost-effective strategy to prevent placental malaria is available and may reduce mother-to-infant HIV transmission in malarious areas. Updated results from this study will be presented.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Africa South of the Sahara
- Disease Transmission, Vertical
- Female
- HIV Infections
- HIV Seropositivity
- HIV-1
- Humans
- Infant
- Kenya
- Malaria
- Malawi
- Mothers
- Parasitemia
- Placenta
- Pregnancy
- Prospective Studies
- transmission
Other ID:
UI: 102228898
From Meeting Abstracts