Evaluation of postpartum HIV superinfection and mother-to-child transmission

Redd, Andrew D.; Wendel, Sarah K.J.; Longosz, Andrew F.; Fogel, Jessica M.; Dadabhai, Sufia; Kumwenda, Newton; Sun, Jin; Walker, Michael P.; Bruno, Daniel; Martens, Craig; Eshleman, Susan H.; Porcella, Stephen F.; Quinn, Thomas C.; Taha, Taha E.

doi:10.1097/QAD.0000000000000740

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Evaluation of postpartum HIV superinfection and mother-to-child transmission

7 31 2015
By Redd, Andrew D. ; Wendel, Sarah K.J. ; Longosz, Andrew F. ; ...
http://dx.doi.org/10.1097/QAD.0000000000000740
Source: AIDS. 29(12):1567-1573

[PDF-424.95 KB]

English

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Details:

Alternative Title:

AIDS
Personal Author:

Redd, Andrew D. ; Wendel, Sarah K.J. ; Longosz, Andrew F. ; Fogel, Jessica M. ; Dadabhai, Sufia ; ... More +

Redd, Andrew D. ; Wendel, Sarah K.J. ; Longosz, Andrew F. ; Fogel, Jessica M. ; Dadabhai, Sufia ; Kumwenda, Newton ; Sun, Jin ; Walker, Michael P. ; Bruno, Daniel ; Martens, Craig ; Eshleman, Susan H. ; Porcella, Stephen F. ; Quinn, Thomas C. ; Taha, Taha E. Less -
Description:

Objective

This study examined HIV superinfection (HIV SI) in HIV-infected women postpartum, and its association with mother-to-child transmission (MTCT).

Design

Plasma samples were obtained from HIV-infected women who transmitted HIV to their infants after 6 weeks of age (transmitters, n=91) and HIV-infected women who did not transmit HIV to their infants (non-transmitters, n=91). These women were originally enrolled in a randomized trial for prevention of MTCT of HIV in Malawi (PEPI-Malawi).

Methods

Two HIV genomic regions (p24 and gp41) were analyzed by next generation sequencing (NGS) for HIV SI. HIV SI was established if the follow-up sample contained a new, phylogenetically distinct viral population. HIV SI and transmission risk were examined by multiple logistic regression, adjusted for PEPI study arm, baseline viral load, baseline CD4 cell count, time to resumption of sex, and breastfeeding duration.

Results

Transmitters had lower baseline CD4 cell counts (p=0.001) and higher viral loads (p<0.0001) compared to non-transmitters. There were five cases of SI among transmitters [rate of SI=4.7/100pys person year (pys)] compared to five cases among the non-transmitters (rate of SI=4.4/100pys; p=0.78). HIV SI was not associated with increased risk of post-natal MTCT of HIV after controlling for maternal age, baseline viral load and CD4 cell count (adjusted odds ratio=2.32, p=0.30). Longer breastfeeding duration was independently associated with a lower risk of HIV SI after controlling for study arm and baseline viral load (p=0.05).

Conclusions

There was a significant level of HIV SI in women postpartum, but this was not associated with an increased risk of MTCT via breastfeeding.
Keywords:

[+]

Adult Anti-HIV Agents Breast Feeding CD4 Lymphocyte Count Child, Preschool Female Genotype Genotyping Techniques High-Throughput Nucleotide Sequencing HIV Core Protein P24 HIV Envelope Protein Gp41 HIV Infections Humans Infant Infant, Newborn Infectious Disease Transmission, Vertical Malawi Post-Exposure Prophylaxis Postpartum Period Pregnancy Randomized Controlled Trials As Topic Sequence Analysis, DNA Sexual Behavior Superinfection Viral Load Young Adult
Source:

AIDS. 29(12):1567-1573
Pubmed ID:

26244396
Pubmed Central ID:

PMC4609898
Document Type:

Journal Article
Funding:

5-U50-PS022061-05/PS/NCHHSTP CDC HHSUnited States/ ; 1R01-AI087139/AI/NIAID NIH HHSUnited States/ ; R01 AI087139/AI/NIAID NIH HHSUnited States/ ; ImNIH/Intramural NIH HHSUnited States/ ; U50 PS022061/PS/NCHHSTP CDC HHSUnited States/ ; ... More +

5-U50-PS022061-05/PS/NCHHSTP CDC HHSUnited States/ ; 1R01-AI087139/AI/NIAID NIH HHSUnited States/ ; R01 AI087139/AI/NIAID NIH HHSUnited States/ ; ImNIH/Intramural NIH HHSUnited States/ ; U50 PS022061/PS/NCHHSTP CDC HHSUnited States/ ; UM1-AI068613/AI/NIAID NIH HHSUnited States/ ; U50-CC0222061/CC/CDC HHSUnited States/ ; UM1 AI068613/AI/NIAID NIH HHSUnited States/ Less -
Volume:

29
Issue:

12
Collection(s):

CDC Public Access
Main Document Checksum:

[+]

urn:sha256:e25677113d7015caa1e99c82dabdd2e8183c2675dde7e5f375063680ec7a52e3
Download URL:

https://stacks.cdc.gov/view/cdc/35085/cdc_35085_DS1.pdf
File Type:

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	nihms-727372-f0001.jpg	jpeg
	nihms-727372.nxml	xml
	NIHMS727372-supplement-Supplemental_Data_File___doc___tif__pdf__etc__.pdf	pdf

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