"High Risk of HIV-1 Infection for First-Born Twins"

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

"High Risk of HIV-1 Infection for First-Born Twins"

Lancet (12/14/91) Vol. 338, No. 8781, P. 1471
Goedert, James J. et al.

Abstract: HIV-1 infection is more prevalent in first-born twins than in second-born twins, write James J. Goedert and colleagues of the Viral Epidemiology Section and National Cancer Institute in Rockville, Md. In Goedert et al.'s study, 40 investigators from nine countries contributed a variety of data on 100 sets of twins and one set of triplets born to HIV-infected mothers. It was found that HIV-1 infection was more common among first-born twins--in the 66 evaluable sets--than in second-born twins. In 22 sets, only one twin was infected. Among the first-born twins delivered vaginally, 50 percent were infected. First-born twins that were delivered by cesearen accounted for 38 percent of infections, compared to 19 percent of second-born twins delivered by either route. The research indicates that some infants may be infected before delivery, but a significant proportion of HIV-1 transmission occurs as the first twin encounters the cervix and birth canal. Cleansing the birth canal and cesearean delivery might reduce the risk of HIV transmission, the researchers conclude.

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