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- Title
Maternal Malaria and Perinatal HIV Transmission, Western Kenya<sup>1,2</sup>.
- Authors
Ayisi, John G.; Van Eijk, Anna M.; Newman, Robert D.; Ter Kuile, Feiko O.; Ya Ping Shi; Chunfu Yang; Kolczak, Margarette S.; Otieno, Juliana A.; Misore, Ambrose O.; Kager, Piet A.; Lal, Renu B.; Steketee, Richard W.; Nahlen, Bernard L.
- Abstract
To determine whether maternal placental malaria is associated with an increased risk for perinatal mother-to-child HIV transmission (MTCT), we studied HIV-positive women in western Kenya. We enrolled 512 mother-infant pairs; 128 (25.0%) women had placental malaria, and 102 (19.9%) infants acquired HIV perinatally. Log10 HIV viral load and episiotomy or perinea) tear were associated with increased perinatal HIV transmission, whereas low-density placental malaria (<10,000 parasites/µL) was associated with reduced risk (adjusted relative risk [ARR] 0.4). Among women dually infected with malaria and HIV, high-density placental malaria (≥ 10,000 parasites/µL) was associated with increased risk for perinatal MTCT (ARR 2.0), compared to low-density malaria. The interaction between placental malaria and MTCT appears to be variable and complex: placental malaria that is controlled at low density may cause an increase in broad-based immune responses that protect against MTCT; uncontrolled, high-density malaria may simultaneously disrupt placental architecture and generate substantial antigen stimulus to HIV replication and increase risk for MTCT.
- Subjects
KENYA; MALARIA; MATERNAL-fetal exchange; PREGNANCY complications; VIRAL load; IMMUNE response; HIV-positive women
- Publication
Emerging Infectious Diseases, 2004, Vol 10, Issue 4, p643
- ISSN
1080-6040
- Publication type
Article
- DOI
10.3201/eid1004.030303