PROSPECTIVE COMPARISON OF MOTHER-TO-CHILD TRANSMISSION OF HIV-1 AND HIV-2 IN ABIDJAN, IVORY-COAST
PROSPECTIVE COMPARISON OF MOTHER-TO-CHILD TRANSMISSION OF HIV-1 AND HIV-2 IN ABIDJAN, IVORY-COAST
复制标题
DOI：
10.1001/jama.272.6.462
复制
发表时间：
1994-08-10
影响因子：
120.7
通讯作者：
GAYLE, HD
中科院分区：
文献类型：
--
作者：
ADJORLOLOJOHNSON, G;DECOCK, KM;GAYLE, HD
目的.-比较人类免疫缺陷病毒 1 型和 2 型（分别为 HIV-1 和 HIV-2）的母婴传播，并评估孕产妇 HIV-1 和 HIV-2 感染对儿童生存的影响。设计。-前瞻性队列研究。背景-科特迪瓦阿比让社会经济阶层较低地区的妇幼保健中心。参与者。-1990 年至 1990 年期间共有 18 099 名分娩妇女1992年进行了HIV-1和HIV-2抗体检测。对 613 名孕妇及其婴儿进行了前瞻性随访（138 名女性对 HIV-1 有反应，132 名女性对 HIV-2 有反应，69 名女性对两种病毒都有反应，274 名 HIV 血清阴性）。 HIV-1 阳性、HIV-2 阳性、双重反应性和 HIV 血清阴性妇女所生婴儿的存活率。 结果 - 在接受测试的 18 099 名妇女中，9.4% 对单独的 HIV-1 有反应，1.6% 对单独的 HIV-2 有反应，1.0% 对两种病毒都有反应。 HIV-1 的围产期传播率为 24.7%（95% 置信区间 [Cl]，15.8% 至 33.7%），而 HIV-2 的围产期传播率为 1.2%（95% CI，0.0% 至 3.5%）（相对风险，21.3；95% CI，2.9 至 154.3）。总体而言，双重反应性女性的婴儿中有 19.0%（95% Cl，9.0% 至 29.0%）被感染；涉及的 11 名儿童中，10 名感染 HIV-1，1 名感染 HIV-1 和 HIV-2。艾滋病毒血清呈阳性的母亲所生的婴儿存活率较低；对于 HIV-1 阳性、双重反应性、HIV-2 阳性和 HIV 血清阴性妇女的儿童，死亡率分别为每 100 个儿童年 15.1、13.0、6.5 和 3.4 例死亡。 结论：HIV-2 围产期传播率 (1.2%) 远低于 HIV-1 围产期传播率 (24.7%)，这与更好的生存率相关对于感染 HIV-2 的母亲所生的婴儿。具有双重反应性的女性可能会传播这两种病毒，尽管传播通常只涉及 HIV-1。公共卫生指南应纳入有关 HIV-2 围产期传播很少见的建议。
Objective.-To compare mother-to-child transmission of human immunodeficiency virus types 1 and 2 (HIV-1 and HIV-2, respectively) and to assess the impact of maternal HIV-1 and HIV-2 infections on child survival.Design.-Prospective cohort study.Setting-Maternal and child health center in a lower socioeconomic class district of Abidjan, Ivory Coast.Participants.-A total of 18 099 women delivering between 1990 and 1992 were tested for HIV-1 and HIV-2 antibodies. A cohort of 613 pregnant women and their infants was followed prospectively (138 women reactive to HIV-1, 132 reactive to HIV-2, 69 reactive to both viruses, and 274 HIV-seronegative).Main Outcome Measures.-Rates of perinatal transmission for HIV-1, HIV-2, and both viruses, determined from results of serological and polymerase chain reaction tests on children; survival of infants born to HIV-1-positive, HIV-2-positive, dually reactive, and HIV-seronegative women.Results-Of the 18 099 women tested, 9.4% were reactive to HIV-1 alone, 1.6% to HIV-2 alone, and 1.0% to both viruses. The rate of perinatal transmission of HIV-1 was 24.7% (95% confidence interval [Cl], 15.8% to 33.7%), compared with 1.2% (95% Cl, 0.0% to 3.5%) for HIV-2 (relative risk, 21.3; 95% Cl, 2.9 to 154.3). Overall, 19.0% (95% Cl, 9.0% to 29.0%) of infants of dually reactive women became infected; of the 11 children concerned, 10 were infected with HIV-1 and one with HIV-1 and HIV-2. Infants of HIV-seropositive mothers had a reduced survival; mortality rates were 15.1, 13.0, 6.5, and 3.4 deaths per 100 child-years, respectively, for children of HIV-1-positive, dually reactive, HIV-2-positive, and HIV-seronegative women.Conclusions-The rate of perinatal transmission of HIV-2 (1.2%) was much lower than the rate of perinatal transmission of HIV-1 (24.7%), and this was associated with more favorable survival for infants of HIV-2-infected mothers. Dually reactive women could transmit both viruses, although transmission usually involved HIV-1 only. Public health guidelines should incorporate advice that perinatal transmission of HIV-2 is rare.