1. Placental malaria and mother-to-child transmission of human immunodeficiency virus-1 in rural Rwanda.
- Author
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Bulterys PL, Chao A, Dalai SC, Zink MC, Dushimimana A, Katzenstein D, Saah AJ, and Bulterys M
- Subjects
- Adult, Case-Control Studies, Female, Humans, Infant, Newborn, Pregnancy, Rwanda epidemiology, Young Adult, HIV Infections transmission, HIV-1 physiology, Infectious Disease Transmission, Vertical statistics & numerical data, Placenta parasitology, Pregnancy Complications, Infectious epidemiology
- Abstract
We conducted a nested case-control study of placental malaria (PM) and mother-to-child transmission (MTCT) of human immunodeficiency virus-1 (HIV-1) within a prospective cohort of 627 mother-infant pairs followed from October 1989 until April 1994 in rural Rwanda. Sixty stored placentas were examined for PM and other placental pathology, comparing 20 HIV-infected mother-infant (perinatal transmitter) pairs, 20 HIV-uninfected pairs, and 20 HIV-infected mothers who did not transmit to their infant perinatally. Of 60 placentas examined, 45% showed evidence of PM. Placental malaria was associated with increased risk of MTCT of HIV-1 (adjusted odds ratio [aOR] = 6.3; 95% confidence interval [CI] = 1.4-29.1), especially among primigravidae (aOR = 12.0; 95% CI = 1.0-150; P < 0.05). Before antiretroviral therapy or prophylaxis, PM was associated with early infant HIV infection among rural Rwandan women living in a hyper-endemic malaria region. Primigravidae, among whom malaria tends to be most severe, may be at higher risk.
- Published
- 2011
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