Serodiscordant twins: A case report of vertical HIV transmission during PMTCT option B+ role out

Abstract

Similar factors promote vertical transmission of HIV in singleton pregnancies as in twin pregnancies. MTCT (mother to child transmission) in single pregnancies are associated with viral, maternal, obstetrical, foetal and infant factors. In twin pregnancies factors associated with serodiscordance are not clear. Mechanisms implicated are uterine contractions, mixing mother and foetal blood (2 nd twin), broken skin, exposure in the birth canal (1 st twin). Since Antiretroviral Therapy as Prevention of MTCT (ART PMTCT) the most important factor associated with vertical HIV transmission is the Viral Load (VL). Due to early attainments of NSP goals of 2% 6 weeks and 5% 18 months HIV rates Elimination of MTCT (EMTCT) became a possibility. New challenges en route to eliminate HIV are interventions to reverse HIV latency and to induce an effective anti-HIV immune response. Twin studies could be utilised to improve the understanding of the role of host genetics, co-infections and HIV sub-types in HIV transmission.Correspondence to: Carien Lion-Cachet, Sub-District Family Physician, North West

Vertical Transmission Rate of Human Immunodeficiency Virus Exposed Twin Pregnancies and Associated Factors in West Bengal, India: a Retrospective Cohort Study

“…gestational age of mother for HIV detection. This factor was also found to be a significant risk factor for singleton pregnancy (18) in one of the authors' earlier study (19). In addition to that vaginal delivery, advancing maternal age and low birth weight were also found to be associated with increased risk of HIV transmission in singleton pregnancy.…”