Chlamydia and Gonorrhea in HIV-Infected Pregnant Women and Infant HIV Transmission
Kristina Adachi, Jeffrey D Klausner, Claire C Bristow, Jiahong Xu, Bonnie Ank, Mariza G Morgado, D Heather Watts, Fred Weir, David Persing, Lynne M Mofenson, Valdilea G Veloso, Jose Henrique Pilotto, Esau Joao, Karin Nielsen-Saines, NICHD HPTN 040 Study Team, Glenda Gray, Gerhard Theron, Breno Santos, Rosana Fonseca, Regis Kreitchmann, Jorge Pinto, Marisa Mussi-Pinhata, Ribeirao Preto, Mariana Ceriotto, Daisy Maria Machado, George Siberry, Yvonne J Bryson, David Geffen, Beatriz Grinsztejn, Fundacao Oswaldo Cruz, Francisco I Bastos, Edgardo Szyld, Silvia Marzo, Flavia Faleiro Ferreira, Fabiana Kakehasi, Belo Horizonte, Rita Lira, Debora Fernandes Coelho, Alberto Sanseverino, Luis Carlos Ribeiro, M Leticia Santos Cruz, Ezequias Martins, Jacqueline Anita de Menezes, Luisa Andrea Torres Salgado, Ana Valeria Cordovil, Andréa Gouveia, Priscila Mazzucanti, Jorge Eurico Ribeiro, Geraldo Duarte, Adriana Aparecida Tiraboschi Barbaro, Carolina Sales Vieira, Regina Succi, Mark Cotton, Jeanne Louw, Elke Maritz, Sarita Lalsab, Shini Legoete, James Alasdair McIntyre, Mandisa Nyati, Chris Hani Baragwanath, Allison Agwu, Jean Anderson, Joan Bess, Jonathan Ellen, Todd Noletto, Nancy Hutton, Carol Delany, Robert M Lawrence, Chas Griggs, Mobeen Rathore, Kathleen Thoma, Michelle Tucker, Audra Deveikis, Susan Marks, Linda Bettica, James M Oleske, Midnela Acevedo Flores, Elvia Pérez, Ronaldo I Moreira, Marilia Santini de Oliveira, Monica Derrico, Valéria Ribeiro, Thiago Torres, Ruth Dickover, Mark Mirochnick, Margaret Camarca, James Bethel, Emmanuel Aluko, Yolanda Bertucci, Jennifer Bryant, Patty Chen, Barbara Driver, Ruby Duston, Adriana Ferreira, Priya Guyadeen, Sarah Howell, Marsha Johnson, Linda Kaufman, Naomi Leshabane, Lilya Meyerson, Rita Patel, Lubima Petrova, Susan Raitt, Scott Watson, Yiling Xu, Eunice Yu, Jennifer Read, Jack Moye, Elizabeth Smith, Sheryl Zwerski, Kristina Adachi, Jeffrey D Klausner, Claire C Bristow, Jiahong Xu, Bonnie Ank, Mariza G Morgado, D Heather Watts, Fred Weir, David Persing, Lynne M Mofenson, Valdilea G Veloso, Jose Henrique Pilotto, Esau Joao, Karin Nielsen-Saines, NICHD HPTN 040 Study Team, Glenda Gray, Gerhard Theron, Breno Santos, Rosana Fonseca, Regis Kreitchmann, Jorge Pinto, Marisa Mussi-Pinhata, Ribeirao Preto, Mariana Ceriotto, Daisy Maria Machado, George Siberry, Yvonne J Bryson, David Geffen, Beatriz Grinsztejn, Fundacao Oswaldo Cruz, Francisco I Bastos, Edgardo Szyld, Silvia Marzo, Flavia Faleiro Ferreira, Fabiana Kakehasi, Belo Horizonte, Rita Lira, Debora Fernandes Coelho, Alberto Sanseverino, Luis Carlos Ribeiro, M Leticia Santos Cruz, Ezequias Martins, Jacqueline Anita de Menezes, Luisa Andrea Torres Salgado, Ana Valeria Cordovil, Andréa Gouveia, Priscila Mazzucanti, Jorge Eurico Ribeiro, Geraldo Duarte, Adriana Aparecida Tiraboschi Barbaro, Carolina Sales Vieira, Regina Succi, Mark Cotton, Jeanne Louw, Elke Maritz, Sarita Lalsab, Shini Legoete, James Alasdair McIntyre, Mandisa Nyati, Chris Hani Baragwanath, Allison Agwu, Jean Anderson, Joan Bess, Jonathan Ellen, Todd Noletto, Nancy Hutton, Carol Delany, Robert M Lawrence, Chas Griggs, Mobeen Rathore, Kathleen Thoma, Michelle Tucker, Audra Deveikis, Susan Marks, Linda Bettica, James M Oleske, Midnela Acevedo Flores, Elvia Pérez, Ronaldo I Moreira, Marilia Santini de Oliveira, Monica Derrico, Valéria Ribeiro, Thiago Torres, Ruth Dickover, Mark Mirochnick, Margaret Camarca, James Bethel, Emmanuel Aluko, Yolanda Bertucci, Jennifer Bryant, Patty Chen, Barbara Driver, Ruby Duston, Adriana Ferreira, Priya Guyadeen, Sarah Howell, Marsha Johnson, Linda Kaufman, Naomi Leshabane, Lilya Meyerson, Rita Patel, Lubima Petrova, Susan Raitt, Scott Watson, Yiling Xu, Eunice Yu, Jennifer Read, Jack Moye, Elizabeth Smith, Sheryl Zwerski
Abstract
Background: Sexually transmitted infections (STIs) such as Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) can lead to adverse pregnancy and neonatal outcomes. The prevalence of STIs and its association with HIV mother-to-child transmission (MTCT) were evaluated in a substudy analysis from a randomized, multicenter clinical trial.
Methodology: Urine samples from HIV-infected pregnant women collected at the time of labor and delivery were tested using polymerase chain reaction testing for the detection of CT and NG (Xpert CT/NG; Cepheid, Sunnyvale, CA). Infant HIV infection was determined by HIV DNA polymerase chain reaction at 3 months.
Results: Of the 1373 urine specimens, 249 (18.1%) were positive for CT and 63 (4.6%) for NG; 35 (2.5%) had both CT and NG detected. Among 117 cases of HIV MTCT (8.5% transmission), the lowest transmission rate occurred among infants born to CT- and NG-uninfected mothers (8.1%) as compared with those infected with only CT (10.7%) and both CT and NG (14.3%; P = 0.04). Infants born to CT-infected mothers had almost a 1.5-fold increased risk for HIV acquisition (odds ratio, 1.47; 95% confidence interval, 0.9-2.3; P = 0.09).
Conclusions: This cohort of HIV-infected pregnant women is at high risk for infection with CT and NG. Analysis suggests that STIs may predispose to an increased HIV MTCT risk in this high-risk cohort of HIV-infected women.
Trial registration: ClinicalTrials.gov NCT00099359.
Conflict of interest statement
Disclosures and Conflict of Interest: None of the authors have any financial relationships or conflicts of interest to disclose except for the following: Fred Weir PhD is the Director of Research and Development at Cepheid. David Persing MD, PhD is the Executive Vice President, Chief Medical & Technology Officer of Cepheid.
Source: PubMed