期刊
PLOS MEDICINE
卷 3, 期 1, 页码 70-75出版社
PUBLIC LIBRARY SCIENCE
DOI: 10.1371/journal.pmed.0030010
关键词
-
资金
- NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES [R01AI049084, T32AI007151, R21AI065369, P30AI050410] Funding Source: NIH RePORTER
- NIAID NIH HHS [AI07151-26, R01 AI049084, P30 AI050410, T32 AI007151, AI49084, P30-AI50410, R21 AI065369, AI065369-01] Funding Source: Medline
- Wellcome Trust Funding Source: Medline
Background Between 25% and 35% of infants born to HIV-infected mothers become HIV-1 infected. One potential route of mother-to-child transmission (MTCT) could be through a breakdown in the placental barrier (i.e., maternal-fetal microtransfusions). Methods and Findings Placental alkaline phosphatase (PLAP) is a 130-kD maternal enzyme that cannot cross the intact placental barrier. We measured PLAP activity in umbilical vein serum as an indicator of maternal-fetal microtransfusion, and related this to the risk of HIV-1 IVITCT. A case-cohort study was conducted of 149 women randomly selected from a cohort of HIV-1-infected pregnant Malawians; these women served as a reference group for 36 cases of in utero MTCT and 43 cases of intrapartum (IP) IVITCT. Cord PLAID activity was measured with an immunocatalytic assay. Infant HIV status was determined by real-time PCR. The association between cord PLAID activity and HIV-1 IVITCT was measured with logistic regression using generalized estimating equations. Among vaginal deliveries, PLAID was associated with IP MTCT (risk ratio, 2.25 per log(10) ng/ml PLAP; 95% confidence interval, 0.95-5.32) but not in utero MTCT. In a multivariable model adjusted for HIV-1 RNA load, choripamnionitis, and self-reported fever, the risk of IP MTCT almost tripled for every loglo increase in cord PLAP activity (risk ratio, 2.87; 95% confidence interval, 1.05-7.83). Conclusion These results suggest that during vaginal deliveries, placental microtransfusions are a risk factor for IP HIV-1 IVITCT. Future studies are needed to identify factors that increase the risk for microtransfusions in order to prevent IP HIV-1 IVITCT.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据