Sexual behavior and injection drug use during pregnancy and vertical transmission of HIV-1
Sexual behavior and injection drug use during pregnancy and vertical transmission of HIV-1
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DOI：
10.1097/00042560-199705010-00012
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发表时间：
1997-05-01
期刊：
影响因子：
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通讯作者：
Goedert, JJ
中科院分区：
文献类型：
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作者：
Bulterys, M;Landesmam, S;Goedert, JJ
我们评估了母亲的性行为和注射毒品的做法，作为人类免疫缺陷病毒1型（HIV-1）垂直传播的可能危险因素。数据分析来自母亲和婴儿队列研究，这是一项在布鲁克林和纽约布朗克斯进行的前瞻性研究。在1986年至1991年期间，共有207个母婴组被纳入研究，并在妊娠期间进行了长达4年的随访。201对母婴中有49对发生HIV-1传播，总传播率为24.4%（95%置信区间（CI）= 18.7%~ 31.0%）。怀孕前三个月后阴道性交频率的增加与HIV-1的垂直传播正相关（趋势p = 0.03）。注射毒品的终生使用史与垂直传播无关。然而，在怀孕的前三个月后，可卡因和海洛因的混合注射史与HIV-1的垂直传播有关，特别是在CD 4（+）淋巴细胞水平为20%或更高的妇女中（风险比= 4.0; 95% CI = 2.0 - 8.1），在这个队列中，第一个三个月后使用可卡因和海洛因注射毒品占早产和垂直HIV-1传播之间关系的大部分。母亲合并感染丙型肝炎病毒或人类T细胞嗜淋巴细胞病毒I型和II型不能解释这些观察结果，因为合并感染这些病毒对HIV-T传播没有可检测的影响。这些结果表明，母亲的性行为和注射吸毒的做法，在怀孕的第二和第三个三个月可能会改变垂直HIV-1传播的风险。
We evaluated maternal sexual behavior and injection drug use practices as possible risk factors for vertical transmission of human immunodeficiency virus type 1 (HIV-1). Data were analyzed from the Mothers and Infants Cohort Study, a prospective study in Brooklyn and the Bronx, New York. A total of 207 mother-infant sets were enrolled between 1986 and 1991 and followed for up to 4 years after the enrollment visit during pregnancy. HIV-1 transmission occurred in 49 of 201 mother-infant sets, yielding an overall transmission rate of 24.4% (95% confidence interval (CI) = 18.7% to 31.0%). Increased frequency of vaginal intercourse after the first trimester of pregnancy was positively associated with vertical transmission of HIV-1 (trend p = 0.03). A lifetime history of injection drug use was not associated with vertical transmission. However, a history of combined cocaine and heroin injection after the first trimester of pregnancy was associated with vertical HIV-1 transmission, particularly among women with CD4(+) lymphocyte levels of 20% or higher (risk ratio = 4.0; 95% CI = 2.0 to 8.1), Cocaine and heroin injection drug use after the first trimester accounted for most of the relation between preterm birth and vertical HIV-1 transmission in this cohort. Maternal coinfection with hepatitis C virus or human T-cell lymphotropic virus types I and II could not explain these observations, because coinfection with these viruses had no detectable effect on HIV-T transmission. These results suggest that maternal sexual behavior and injection drug use practices during the second and third trimester of pregnancy may modify the risk of vertical HIV-1 transmission.