Abstract
Objective. We investigated gender-specific risks of mother-to-child transmission (MTCT) at birth and at 6 to 8 weeks among infants born to HIVinfected African women. Design. Follow-up study of infants enrolled in 2 randomized, phase III, clinical trials to prevent MTCT, conducted in Blantyre, Malawi, in southeast Africa. Methods. Infants were enrolled at birth and monitored postnatally, and their HIV status was assessed at birth and at 6 to 8 weeks (assessment beyond 6-8 weeks is ongoing). Statistical analyses were stratified according to gender, and comparisons were made with descriptive, univariate, and multivariate statistical tests. MTCT was estimated at birth and at 6 to 8 weeks among infants who were not infected at birth. Results. Overall, 966 boys and 998 girls were enrolled. The rate of HIV transmission at birth was 9.5% (187 of 1964 infants). However, at birth significantly more girls (12.6%) than boys (6.3%) were infected with HIV. This association remained significant after controlling for maternal viral load and other factors. Among infants who were uninfected at birth, 8.7% (135 of 1554 infants) acquired HIV by 6 to 8 weeks; of these infants, more girls acquired HIV (10.0%), compared with boys (7.4%). Conclusions. Female infants may be more susceptible to HIV infection before birth and continuing after birth. Alternatively, in utero mortality rates of HIV-infected male infants may be disproportionately higher and thus more HIV-infected female infants are born. In areas of sub-Saharan Africa, where HIV infection rates are high among women of reproductive age, the magnitude of the gender transmission differences observed in this study could have clinical, preventive, and demographic implications.
| Original language | English (US) |
|---|---|
| Journal | Pediatrics |
| Volume | 115 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 2005 |
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Keywords
- Acquisition
- Africa
- Gender
- HIV
- Mother-to-child transmission
- Susceptibility
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
Cite this
Gender differences in perinatal HIV acquisition among African infants. / Taha, Taha E; Nour, Samah; Kumwenda, Newton I.; Broadhead, Robin L.; Fiscus, Susan A.; Kafulafula, George; Nkhoma, Chiwawa; Chen, Shu; Hoover, Donald R.
In: Pediatrics, Vol. 115, No. 2, 02.2005.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Gender differences in perinatal HIV acquisition among African infants
AU - Taha, Taha E
AU - Nour, Samah
AU - Kumwenda, Newton I.
AU - Broadhead, Robin L.
AU - Fiscus, Susan A.
AU - Kafulafula, George
AU - Nkhoma, Chiwawa
AU - Chen, Shu
AU - Hoover, Donald R.
PY - 2005/2
Y1 - 2005/2
N2 - Objective. We investigated gender-specific risks of mother-to-child transmission (MTCT) at birth and at 6 to 8 weeks among infants born to HIVinfected African women. Design. Follow-up study of infants enrolled in 2 randomized, phase III, clinical trials to prevent MTCT, conducted in Blantyre, Malawi, in southeast Africa. Methods. Infants were enrolled at birth and monitored postnatally, and their HIV status was assessed at birth and at 6 to 8 weeks (assessment beyond 6-8 weeks is ongoing). Statistical analyses were stratified according to gender, and comparisons were made with descriptive, univariate, and multivariate statistical tests. MTCT was estimated at birth and at 6 to 8 weeks among infants who were not infected at birth. Results. Overall, 966 boys and 998 girls were enrolled. The rate of HIV transmission at birth was 9.5% (187 of 1964 infants). However, at birth significantly more girls (12.6%) than boys (6.3%) were infected with HIV. This association remained significant after controlling for maternal viral load and other factors. Among infants who were uninfected at birth, 8.7% (135 of 1554 infants) acquired HIV by 6 to 8 weeks; of these infants, more girls acquired HIV (10.0%), compared with boys (7.4%). Conclusions. Female infants may be more susceptible to HIV infection before birth and continuing after birth. Alternatively, in utero mortality rates of HIV-infected male infants may be disproportionately higher and thus more HIV-infected female infants are born. In areas of sub-Saharan Africa, where HIV infection rates are high among women of reproductive age, the magnitude of the gender transmission differences observed in this study could have clinical, preventive, and demographic implications.
AB - Objective. We investigated gender-specific risks of mother-to-child transmission (MTCT) at birth and at 6 to 8 weeks among infants born to HIVinfected African women. Design. Follow-up study of infants enrolled in 2 randomized, phase III, clinical trials to prevent MTCT, conducted in Blantyre, Malawi, in southeast Africa. Methods. Infants were enrolled at birth and monitored postnatally, and their HIV status was assessed at birth and at 6 to 8 weeks (assessment beyond 6-8 weeks is ongoing). Statistical analyses were stratified according to gender, and comparisons were made with descriptive, univariate, and multivariate statistical tests. MTCT was estimated at birth and at 6 to 8 weeks among infants who were not infected at birth. Results. Overall, 966 boys and 998 girls were enrolled. The rate of HIV transmission at birth was 9.5% (187 of 1964 infants). However, at birth significantly more girls (12.6%) than boys (6.3%) were infected with HIV. This association remained significant after controlling for maternal viral load and other factors. Among infants who were uninfected at birth, 8.7% (135 of 1554 infants) acquired HIV by 6 to 8 weeks; of these infants, more girls acquired HIV (10.0%), compared with boys (7.4%). Conclusions. Female infants may be more susceptible to HIV infection before birth and continuing after birth. Alternatively, in utero mortality rates of HIV-infected male infants may be disproportionately higher and thus more HIV-infected female infants are born. In areas of sub-Saharan Africa, where HIV infection rates are high among women of reproductive age, the magnitude of the gender transmission differences observed in this study could have clinical, preventive, and demographic implications.
KW - Acquisition
KW - Africa
KW - Gender
KW - HIV
KW - Mother-to-child transmission
KW - Susceptibility
UR - http://www.scopus.com/inward/record.url?scp=17844405335&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=17844405335&partnerID=8YFLogxK
U2 - 10.1542/peds.2004-1590
DO - 10.1542/peds.2004-1590
M3 - Article
C2 - 15687425
AN - SCOPUS:17844405335
VL - 115
JO - Pediatrics
JF - Pediatrics
SN - 0031-4005
IS - 2
ER -