Predictors of Early and Late Mother-to-Child Transmission of HIV in a Breastfeeding Population: HIV Network for Prevention Trials 012 Experience, Kampala, Uganda

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dc.contributor.authorMmiro, Francis A.
dc.contributor.authorAizire, Jim
dc.contributor.authorMwatha, Anthony K.
dc.contributor.authorEshleman, Susan H.
dc.contributor.authorDonnell, Deborah
dc.contributor.authorFowler, Mary Glenn
dc.contributor.authorNakabiito, Clemensia
dc.contributor.authorMusoke, Philippa M.
dc.contributor.authorJackson, J. Brooks
dc.contributor.authorGuay, Laura A.
dc.date.accessioned2022-01-31T12:45:13Z
dc.date.available2022-01-31T12:45:13Z
dc.date.issued2009
dc.description.abstractTo determine the predictors for early versus later (breastfeeding) transmission of HIV-1.Secondary data analysis was performed on HIV Network for Prevention Trials 012, a completed randomized clinical trial assessing the relative efficacy of nevirapine (NVP) versus zidovudine in reducing mother-to-child transmission (MTCT) of HIV-1. We used Cox regression analysis to assess risk factors for MTCT. The ViroSeq HIV genotyping and a sensitive point mutation assay were used to detect NVP resistance mutations.In this subset analyses, 122 of 610 infants were HIV infected, of whom 99 (81.1%) were infected early (first positive polymerase chain reaction ≤56 days). Incidence of MTCT after 56 days was low [0.7% per month (95% confidence interval, CI: 0.4 to 1.0)], but continued through 18 months. In multivariate analyses, early MTCT “factors” included NVP versus zidovudine (hazard ratio (HR) = 0.57, 95% CI: 0.38 to 0.86), pre-entry maternal viral load (VL, HR = 1.76, 95% CI: 1.28 to 2.41), and CD4 cell count (HR = 1.16, 95% CI: 1.05 to 1.28). Maternal VL (6–8 weeks) was associated with late MTCT (HR = 3.66, 95% CI: 1.78 to 7.50), whereas maternal NVP resistance (6–8 weeks) was not.Maternal VL was the best predictor of both early and late transmission. Maternal NVP resistance at 6–8 weeks did not predict late transmission.en_US
dc.identifier.citationMmiro, F. A., Aizire, J., Mwatha, A. K., Eshleman, S. H., Donnell, D., Fowler, M. G., ... & Guay, L. A. (2009). Predictors of early and late mother-to-child transmission of HIV in a breastfeeding population: HIV Network for Prevention Trials 012 experience, Kampala, Uganda. Journal of acquired immune deficiency syndromes (1999), 52(1), 32.doi: 10.1097/QAI.0b013e3181afd352en_US
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/1673
dc.language.isoenen_US
dc.publisherJournal of acquired immune deficiency syndromesen_US
dc.subjectearly/late postnatal, MTCT, HIV-1en_US
dc.titlePredictors of Early and Late Mother-to-Child Transmission of HIV in a Breastfeeding Population: HIV Network for Prevention Trials 012 Experience, Kampala, Ugandaen_US
dc.typeArticleen_US
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