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n Medical Technology SA - Maternal viraemia and mother to child transmission of HIV
Background : Mother-to-child transmission (MTCT) of HIV can occur perinatally and postnatally. Mechanisms of antepartum and intrapartum transmission of HIV include transfer of the virus via maternal blood and transplacental exposure. Understanding the mechanisms of transfer can lead to identification of risk factors in vertical transmission
Study Design and Methods: This study aims to demonstrate the relationship between the viral load and CD4+ cell counts of HIV-1 infected mothers and their babies at birth. Peripheral blood samples were obtained from fifty five mothers at delivery and their babies within the first 48 hours of birth. HIV viral load using Roché Amplicor Version 1.5, Germany and CD4+ cell counts were performed on plasma and blood samples obtained from all mother-baby pairs in the study.
Results : The pooled rate of transmission from HIV-1 infected mothers to their babies was 0.27 (95% CI 0.15-0.39). Maternal viraemia was significantly associated with transmission of infection to babies (p = 0.047). The odds ratio indicated that for every 1 log increase in maternal viral load the babies were 3.1 times more likely to acquire the infection (Exp (B) = 3.137 (95% CI, 1.015-9.696). No significant association was observed between the viral load of mothers and their CD4+ cell counts (p = 0.134).
Conclusion: The findings suggested that maternal HIV-1 RNA is a strong predictor of risk in untreated HIV-1 positive mothers and is a valuable prognostic marker for mother-to-child transmission.
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