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Title

Increased risk of HIV-1 transmission in pregnancy: a prospective study among African HIV-1 serodiscordant couples

Authors

 

Network Affiliation

 

Organization

Mugo NR, Med M, Heffron R

Journal Name

AIDS

Publication Date

7/21/2011

PubMed Search

http://www.ncbi.nlm.nih.gov/pubmed/21785321

Link to full-text

 

PMID

21785321

Abstract

BACKGROUND:

Physiologic and behavioral changes during pregnancy may alter HIV-1 susceptibility and infectiousness. Prospective studies exploring pregnancy and HIV-1 acquisition risk in women have found inconsistent results. No study has explored the effect of pregnancy on HIV-1 transmission risk from HIV-1 infected women to male partners.

METHODS:

In a prospective study of African HIV-1 serodiscordant couples, we evaluated the relationship between pregnancy and the risk of 1) HIV-1 acquisition among women and 2) HIV-1 transmission from women to men.

RESULTS:

3321 HIV-1 serodiscordant couples were enrolled, 1085 (32.7%) with HIV-1 susceptible female partners and 2236 (67.3%) with susceptible male partners. HIV-1 incidence in women was 7.35 versus 3.01 per 100 person-years during pregnant and nonpregnant periods (hazard ratio [HR] 2.34, 95% confidence interval [CI] 1.33-4.09). This effect was attenuated and not statistically significant after adjusting for sexual behavior and other confounding factors (adjusted HR 1.71, 95% CI 0.93-3.12). HIV-1 incidence in male partners of infected women was 3.46 versus 1.58 per 100 person-years when their partners were pregnant versus not pregnant (HR 2.31, 95% CI 1.22-4.39). This effect was not attenuated in adjusted analysis (adjusted HR 2.47, 95% CI 1.26-4.85).

CONCLUSIONS:

HIV-1 risk increased two-fold during pregnancy. Elevated risk of HIV-1 acquisition in pregnant women appeared in part to be explained by behavioral and other factors. This is the first study to show pregnancy increased the risk of female-to-male HIV-1 transmission, which may reflect biological changes of pregnancy that could increase HIV-1 infectiousness.

Keywords

 

Topic

Risk Assessment; Serodiscordant Couples; Women; MTCT

Attachments

Created at 7/29/2011 11:31 AM by Mooney, Jessica L
Last modified at 7/29/2011 11:31 AM by Mooney, Jessica L