Maternal HIV-1 and HIV-2 infection and child survival in The Gambia

M O Ota, D O'Donovan, A S Alabi, P Milligan, L K Yamuah, P T N'Gom, E Harding, K Ariyoshi, Andrew Wilkins, H C Whittle

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Abstract

OBJECTIVE: To compare the survival of children born to HIV-1 or HIV-2 seropositive mothers with that of children born to HIV-seronegative mothers and to evaluate risk factors for mortality.

DESIGN: Physician-blinded prospective study.

METHODS: One hundred and one HIV-1-seropositive, 243 HIV-2-seropositive pregnant women, and 468 HIV-seronegative women (control group) matched by age, parity, and health centre, were followed up in a study of mother-to-child transmission of HIV. Mothers and children were seen at 2 and 6 months of age and subsequently followed at 3-monthly intervals up to 18 months of age. HIV infection in children was diagnosed by polymerase chain reaction at 2, 9 or 18 months and by antibody assays at 18 months.

RESULTS: Fifteen per cent of children born to HIV-1-infected mothers died compared with 7% of children born to HIV-2-infected mothers [hazard ratio, 2.3; 95% confidence interval (CI), 1.1-4.7; P = 0.02], and 6% of HIV-seronegative mothers (hazard ratio, 2.6; 95% CI, 1.4-5.0; P = 0.003). Six of the 17 children known to be HIV-1 infected died compared with none among the eight HIV-2-infected children (P = 0.13). High proviral load in the babies, high antenatal maternal RNA plasma viral load, and maternal death increased child mortality significantly.

CONCLUSIONS: More children born to HIV-1-infected mothers died in comparison with those born to HIV-2-infected mothers or to mothers from the control group. This effect was due to excess death in HIV-1-infected infants which was associated with a high viral load in the affected mother and child.

Original languageEnglish
Pages (from-to)435-9
Number of pages5
JournalAIDS (London, England)
Volume14
Issue number4
Publication statusPublished - 10 Mar 2000

Keywords

  • Female
  • Gambia/epidemiology
  • HIV Infections/mortality
  • HIV-1/isolation & purification
  • HIV-2/isolation & purification
  • Humans
  • Infant
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical
  • Mothers
  • Outcome Assessment (Health Care)
  • Pregnancy
  • Pregnancy Complications, Infectious
  • Pregnancy Outcome
  • Survival Rate
  • Viral Load

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    Ota, M. O., O'Donovan, D., Alabi, A. S., Milligan, P., Yamuah, L. K., N'Gom, P. T., Harding, E., Ariyoshi, K., Wilkins, A., & Whittle, H. C. (2000). Maternal HIV-1 and HIV-2 infection and child survival in The Gambia. AIDS (London, England), 14(4), 435-9.