An assessment of the timing of mother-to-child transmission of human immunodeficiency virus type 1 by means of polymerase chain reaction

J Acquir Immune Defic Syndr (1988). 1994 Sep;7(9):952-7.

Abstract

To approximate the contributions of in utero, intrapartum, and postnatal transmission of human immunodeficiency virus type-1 (HIV-1) and to evaluate polymerase chain reaction (PCR) as a diagnostic tool for pediatric HIV infection, blood was collected at birth (cord blood), and at 3, 6-12, and 13-24 months in 218 children born to HIV-1-seropositive mothers in Kigali, Rwanda. Proviral DNA was detected by a double PCR using two sets of three primers (gag, pol, and env). Pediatric HIV-1 infection was defined according to serological and clinical criteria. The probability of having a positive PCR at a given time was calculated by a nonparametric method. Among children with unequivocal evidence of infection (n = 47), it was 30.5% on cord blood and 80.6% at 3 months. Thus, in children born to HIV-1-infected mothers, the estimated rate of transmission in the late postnatal period is 4.9%, and the rate of transmission in the intrapartum plus postnatal periods is 17.6%. Among 117 HIV-1-uninfected children born to HIV-1-infected mothers, six (5%) had a false-positive PCR on cord blood. These results should be taken into account in designing intervention trials aimed at reducing mother-to-child transmission of HIV-1.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Feeding
  • Cohort Studies
  • Confidence Intervals
  • DNA, Viral / blood*
  • Female
  • Fetal Blood / microbiology
  • Follow-Up Studies
  • HIV Antibodies / blood
  • HIV Infections / transmission*
  • HIV-1 / genetics*
  • Humans
  • Infant
  • Infant, Newborn
  • Polymerase Chain Reaction*
  • Pregnancy
  • Pregnancy Complications, Infectious* / blood
  • Probability
  • Prospective Studies
  • Rwanda
  • Time Factors

Substances

  • DNA, Viral
  • HIV Antibodies