Mother-to-child transmission of HIV-1 in Congo, central Africa

Lallemant, Marc; S, Le Coeur; Samba, L; Cheynier, D.; Mpele, P.; Nzingoula, S.; Essex, Max

doi:10.1097/00002030-199410000-00012

Cited by 39 publications

(9 citation statements)

References 15 publications

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“…The cumulative rate of children lost to follow-up in our cohort was Ͻ12% in 5 years and seems to be particularly low in this African context, strengthening our results. Most published data concerning pediatric HIV infection in developing countries have been either prospective studies that focused primarily on mother-to-child HIV transmission and thus reported limited follow-up of children born to HIV-infected women [13][14][15][16][17][18][19][20][21] or nonprospective studies focusing on HIV-infected children. [22][23][24][25][26] Thus, despite the large body of information that has been accumulated on mother-to-child HIV transmission, only a few prospective studies, focusing specifically on natural history in HIV-infected children, have been published in developing countries.…”

Section: Discussionmentioning

confidence: 99%

Natural History of Human Immunodefiency Virus Type 1 Infection in Children: A Five-Year Prospective Study in Rwanda

Spira

Lepage

Msellati³

et al. 1999

Pediatrics

212

148

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Section: Discussionmentioning

confidence: 99%

Natural History of Human Immunodefiency Virus Type 1 Infection in Children: A Five-Year Prospective Study in Rwanda

Spira

Lepage

Msellati³

et al. 1999

Pediatrics

212

148

View full text Add to dashboard Cite

show abstract

“…In contrast to the data from HIV-positive adults in whom the risk of tuberculosis is increased, studies of the association between HIV infection and TB in children have provided con icting data (20). Cross-sectional studies have reported co-infection in 11-64% of African children but longitudinal and mortality data have not demonstrated an increased incidence of TB in HIVpositive children (21)(22)(23)(24). Differences in study design, sampling methods and dif culties in diagnosing both infections, but particularly tuberculosis may account for these discrepancies.…”

Section: Discussionmentioning

confidence: 99%

Aetiology and outcome of pneumonia in human immunodeficiency virus‐infected children hospitalized in South Africa

et al. 2001

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To determine the aetiology and outcome of pneumonia in human immunodeficiency virus (HIV)‐infected children, we prospectively investigated 250 children hospitalized with pneumonia who were known or clinically suspected to be HIV‐positive, or who required intensive care support in Cape Town, South Africa. Blood culture, induced sputum or bronchoalveolar lavage nasopharyngeal aspirate and gastric lavage were performed. Of the total, 151 children (60.4%) were HIV‐infected. Pneumocystis carinii pneumonia (PCP), occurring in 19 (7.6%) children (15 HIV‐positive), was the AIDS‐defining infection in 20.3%. The incidence and type of bacteraemia (14.3%) were similar in HIV‐positive and HIV‐negative patients; S. pneumoniae (5%) and S. aureus (2%) were the predominant isolates. Sputum or BAL cultures yielded bacteria in 145 of 243 (60%) specimens; viruses were cultured in 37 (15.2%). Bacterial prevalence (including M. tuberculosis in 8%) and anti‐microbial resistance did not differ by HIV status except for S. aureus which was more common in HIV‐infected children. Thirty‐one (20%) HIV‐positive and 8 (8%) HIV‐negative children died [RR 1.16 (95% CI 1.05–1.28), p= 0.008]; using multiple logistic regression, PCP was the only risk factor for mortality (p= 0.03). Conclusion: In South Africa, PCP is an important AIDS‐defining infection in children; bacterial pathogens occur commonly and with a similar prevalence in HIV‐positive and HIV‐negative children hospitalized for pneumonia. HIV‐infected children with pneumonia have a worse outcome than HIV‐negative patients.

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“…In contrast, the progression of infection to a more advanced disease stage in the mother was repeatedly reported to be associated with increased transmission rates (3,(7)(8)(9)(10)(11)(12). The greater infectivity of symptomatic women may be explained by the more profound immunodeficiency and higher viral burden characterizing disease progression.…”

Section: Maternal Disease Progressionmentioning

confidence: 99%

Maternal clinical factors influencing HIV‐1 transmission

1997

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The complex puzzle of maternal factors involved in mother‐to‐child human immunodeficiency virus type 1 (HIV‐1) transmission is being put together. The risk of perinatal infection increases with mother's disease progression, but it remains stable in women seroconverting to HIV‐1 during pregnancy and in consecutive pregnancies. Thus, transmission correlates with the HIV‐1 progression rather than the duration of infection in the mother. Nutritional alterations such as vitamin A deficiency may also have a significant impact, whereas geographic origin and mode of maternal infection are of no influence. Placenta membrane inflammation and concurrent sexually transmitted diseases are other significant covariates. The rate of transmission appears directly correlated with maternal age and inversely with length of gestation. A protective effect of caesarean section has been reported in some observational studies but, being controversial, these results need to be corroborated by randomized trials.

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Mother-to-child transmission of HIV-1 in Congo, central Africa

Cited by 39 publications

References 15 publications

Natural History of Human Immunodefiency Virus Type 1 Infection in Children: A Five-Year Prospective Study in Rwanda

Natural History of Human Immunodefiency Virus Type 1 Infection in Children: A Five-Year Prospective Study in Rwanda

Aetiology and outcome of pneumonia in human immunodeficiency virus‐infected children hospitalized in South Africa

Maternal clinical factors influencing HIV‐1 transmission

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