Mother-To-Child Transmission Of Human Immunodeficiency Virus Type 1: Report From The Nairobi Study

• Published in: The Journal of infectious diseases Vol. 170; no. 5; pp. 1134 - 1140
• Main Authors: Datta, Pratibha, Embree, Joanne E., Kreiss, Joan K., Ndinya-Achola, Jackoniah O., Braddick, Michael, Temmerman, Marleen, Nagelkerke, Nico J. D., Maitha, Gregory, Holmes, King K., Piot, Peter, Pamba, Hannington O., Plummer, Francis A.
• Format: Journal Article
• Language: English
• Published: United States The University of Chicago Press 01-11-1994; University of Chicago Press
• Subjects: Acquired Immunodeficiency Syndrome - epidemiology; Acquired Immunodeficiency Syndrome - transmission; AIDS; AIDS/HIV; Breast Feeding; Child growth; Children; Female; HIV 1; Humans; Infant; Infant, Newborn; Infants; Infections; Infectious Disease Transmission, Vertical; Kenya - epidemiology; Major Articles; Mortality; Mothers; Multivariate Analysis; Pregnancy; Risk Factors; Sexual transmission; Women; Kenya
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/170.5.1134

Mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) is a significant problem in countries with endemic HIV-1 infection. Between 1986 and 1991, 365 children of HIV-L-infected mothers and 363 control children were studied in Kenya. The overall risk of transmission from mother to child, determined by serologic evidence of infection by age ⩽5? 12 months and excess mortality in the HIV-I-exposed group, was 42.8% (range, 27.6%-62.2%). Marriage was the only maternal characteristic associated with transmission (odds ratio, 2.2; 95% confidence interval, 1.2–4.2; P < .05). Children who experienced growth failure were more likely to be infected. In 44% of children ultimately infected, the pattern of antibody response implied intrapartum or postnatal exposure to HIV-1. Of potential postnatal exposures examined, duration of breast-feeding beyond age 15 months and the mother being married were independently associated with increased risk of infection and seroconversion of children. The percentage of HIV infection attributable to breast-feeding ⩽5? 15 months was 32%. The frequency of mother-to-child transmission of HIV-I was high; a substantial proportion of infection occurred postnatally, possibly through breast-feeding.