Perinatal HIV-1 transmission in Nairobi, Kenya: 5 year follow-up.

Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.

Perinatal HIV-1 transmission in Nairobi, Kenya: 5 year follow-up.

Int Conf AIDS. 1991 Jun 16-21;7(1):20 (abstract no. M.C.3). Unique Identifier : AIDSLINE ICA7/1000391
Datta P; Embree J; Ndinya-Achola JO; Kreiss J; Plummer FA; University of Nairobi, Nairobi, Kenya

Abstract: OBJECTIVE: To determine the perinatal HIV-1 transmission rate and evaluate the associated child morbidity and mortality. METHODS: Prospective cohort study of infants born to HIV-1 seropositive mothers (case children) and those born to HIV-1 seronegative mothers (control children). HIV infection in a case child was defined by a positive Western blot (WB+) at 15 months. RESULTS: Three hundred and sixty-one case children and 366 controls have been followed for a mean of 15 (range 0.5-60) months. By survivorship analysis, 12% cases (HIV status indeterminate) and 6% controls died during the first 15 months of life (RR=2.5, p=.03). Of the 79 case children followed for over 15 months, 39% (31/79) are WB positive. A perinatal transmission rate of 45% was estimated based upon WB criteria and mortality rates. A 24% mortality rate for the first 5 years of life was estimated for infected children. The infected survivors are at greater risk of tuberculosis (6.5% vs 0%, p=.02), failure to thrive (FTT) (68% vs 48%, OR=2.3, 95%CI=.9-5.5), pneumonia (32% vs 18%, OR=2.1, 95%CI=.8-5.4), and otitis media (OM) (26% vs 11%, OR=2.8, 95%CI=1-7.8, p=.06) than the controls. The noninfected case children are also at greater risk of OM (27% vs 11%, OR=3, 95%CI=1.3-7, p=.01) and FTT (63% vs 48%, OR=1.8, 95%CI=.9-3.6) than the controls. CONCLUSIONS: Perinatal transmission rate of HIV-1 in this cohort is between 39%-45%. Seventy-five percent of the infected children are likely to survive for at least 5 years before they develop AIDS or die. In addition, we have observed increased morbidity amongst noninfected children born to HIV-1 positive mothers.

Keywords: Cohort Studies Failure to Thrive Follow-Up Studies Human HIV Infections/COMPLICATIONS/MORTALITY/*TRANSMISSION *HIV-1 Infant Mortality Maternal-Fetal Exchange Opportunistic Infections/COMPLICATIONS Prospective Studies ABSTRACT
912130
M91C4066

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