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[PMID]: | 29304083 |
[Au] Autor: | Adachi K; Xu J; Yeganeh N; Camarca M; Morgado MG; Watts DH; Mofenson LM; Veloso VG; Pilotto JH; Joao E; Gray G; Theron G; Santos B; Fonseca R; Kreitchmann R; Pinto J; Mussi-Pinhata MM; Ceriotto M; Machado DM; Bryson YJ; Grinsztejn B; Moye J; Klausner JD; Bristow CC; Dickover R; Mirochnick M; Nielsen-Saines K; NICHD HPTN 040 Study Team |
[Ad] Endereço: | David Geffen UCLA School of Medicine, Los Angeles, CA, United States of America. |
[Ti] Título: | Combined evaluation of sexually transmitted infections in HIV-infected pregnant women and infant HIV transmission. |
[So] Source: | PLoS One;13(1):e0189851, 2018. | [Is] ISSN: | 1932-6203 |
[Cp] País de publicação: | United States |
[La] Idioma: | eng |
[Ab] Resumo: | 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. |
[Mh] Termos MeSH primário: |
Infecções por HIV/complicações Infecções por HIV/transmissão Transmissão Vertical de Doença Infecciosa Complicações Infecciosas na Gravidez Doenças Sexualmente Transmissíveis/complicações
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[Mh] Termos MeSH secundário: |
Adolescente Adulto Infecções por Chlamydia/complicações Chlamydia trachomatis Estudos Transversais Feminino Gonorreia/complicações Seres Humanos Lactente Recém-Nascido Meia-Idade Gravidez Estudos Retrospectivos Fatores de Risco Sífilis/complicações Adulto Jovem
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[Pt] Tipo de publicação: | CLINICAL TRIAL, PHASE III; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T |
[Em] Mês de entrada: | 1801 |
[Cu] Atualização por classe: | 180309 |
[Lr] Data última revisão:
| 180309 |
[Sb] Subgrupo de revista: | IM |
[Da] Data de entrada para processamento: | 180106 |
[Cl] Clinical Trial: | ClinicalTrial
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[St] Status: | MEDLINE |
[do] DOI: | 10.1371/journal.pone.0189851 |
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