Timing of Mother-to Child Transmission of HIV-1 as Determinated by Nested Polymerase Chain Reaction — A Cohort Study in Kigali, Rwanda

  • A. Simonon
  • Ph. Lepage
  • E. Karita
  • D.-G. Hitimana
  • F. Dabis
  • Ph. Msellati
  • F. Nsemgumuremyi
  • Ch. van Goethem
  • A. Bazubagira
  • Ph. van de Perre
Chapter

Abstract

The relative contributions of in utero, intrapartum and postnatal transmission routes of HIV-1 were estimated by PCR’ testing of 218 infants and children born to seropositive mothers, in Kigali, Rwanda. The study population consisted of 47 infected children, 139 uninfected children and 32 with indeterminate status. The infection status was established according to the clinical and serological profiles after a follow-up of 24 months (Ghent 1992). Nested PCR (two rounds of amplification) were performed on PBMCs isolated from serial blood samples. After a follow-up of two years, the estimated mother-to-child transmission rate of HIV-1 is 25.3%. Minimal and maximal estimates of in utero plus intrapartum transmission rate are 7.6% to 17.2% and of postpartum transmission rate 8.0% to 17.7%. The present study confirms that HIV-1 can be transmitted in the postnatal period through breastfeeding.

Keywords

Magnesium Phenol Lactate Agarose Chloroform 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bryson YJ, Luzuriaga K, Sullivan JL, Wara DW. Proposed definitions for in Utero versus intrapartum transmission of HIV-1. N Engl J Med 1992, 327: 1246–1247.PubMedCrossRefGoogle Scholar
  2. Burgard M, Mayaux MJ, Blanche S, et al. The use of viral culture and p24 antigen testing to diagnose human immunodeficiency virus infection in neonates. N Engl J Med 1992, 327: 1192–1197.PubMedCrossRefGoogle Scholar
  3. Courgnaud V, Laure F, et al. Frequent and early in Utero HIV-1 infection. Aids Research and Human Retrovirus 1991, 7: 337–741.CrossRefGoogle Scholar
  4. Douglas GC, King BF. Maternal-fetal transmission of human immunodeficiency virus: a review of possible routes and cellular mechanisms of infection. Clin Infect Dis 1992, 15: 678–691.PubMedCrossRefGoogle Scholar
  5. Dunn DT, Newell ML, Aedes AE and Peckham C. Risk of human immunodeficiency virus type 1 transmission through breastfeeding.Lancet 1992, 340: 585–588.PubMedCrossRefGoogle Scholar
  6. Ehrnst A, Lindgren S, Dictor M, et al. HIV in pregnant women and their offspring; evidence for late transmission. Lancet 1991, 338, 27: 203–207.PubMedCrossRefGoogle Scholar
  7. European Economic Community AIDS Task Force (EEC-ATF). Workshop on Mother-to-Child transmission of HIV. Ghent, Belgium, 17–20 February 1992. Final report. EEC-ATF, Brussels, 1992: 56p.Google Scholar
  8. Krivine A, Firtion G, Coa L, Francouval C, Henrion R, Lebon P. HIV replication during the fisrt weeks of life. Lancet 1992, 339: 1187–1189.PubMedCrossRefGoogle Scholar
  9. Lepage P, Dabis F, Hitimana DG et al. Perinatal transmission of HIV-1: lack of impact of maternal HIV infection on characteristics of livebirths and on neonatal morality in Kigali, Rwanda. AIDS 1991, 5: 295–300.PubMedCrossRefGoogle Scholar
  10. Lepage P, Van de Pene P, Msellati P et al. Mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) and its determinants: a cohort study in Kigali, Rwanda. Am J Epidemiol 1993, in press.Google Scholar
  11. Pizzo PA and Wilfert CM - Pediatrics Aids, Edts Williams&Wilkins: 813pp.Google Scholar
  12. Pizzo PA. Pediatrics Aids: Problems within problems. J Infect Dis 1990, 161: 316–324.PubMedCrossRefGoogle Scholar
  13. Report of consensus workshop, Sienna, Italy, January 17–18, 1992, 5: 1019–1020.Google Scholar
  14. Ruff et al. Breastfeeding and maternal-infant transmission of Human immunodeficiency virus type 1. J Pediatrics 1992: 325–328.CrossRefGoogle Scholar
  15. Saiki RK, Bugawan TL, Horn GT, Mullis KB, Ehrlich HA. Analysis of enzymatically amplified beta-globin and HLA-DQ alpha DNA with allele-specific oligonucleotide probes. Nature 1986, 324: 163–66.PubMedCrossRefGoogle Scholar
  16. Tudor-Williams G. Early diagnosis of vertically acquired HIV-1 infection. AIDS 1991, 5: 103–105.PubMedCrossRefGoogle Scholar
  17. Van de Perre P, Lepage P, Homsy J and Dabis F. Mother-to-Infant transmission of HIV-1 by breast milk: presumed innocent or presumed guilty? Clin Infect Dis 1992, 15: 502–507.PubMedCrossRefGoogle Scholar
  18. Van de Pene P, Simonon A, Msellati P, et al. Postnatal transmission of human immunodeficiency virus type 1 from mother-to-infant. A cohort study. N Engl J Med 1991, 325:593–598.CrossRefGoogle Scholar
  19. World Health Organization. Acquired immunodeficiency syndrome (AIDS) Wkly Epidemiol Rep 1986, 61: 69–73.Google Scholar
  20. World Health Organization, Global Programme on Aids. Consensus statement from the WHO/ Unicef consultation on HIV transmission and breast feeding. Weekly Epid Rep 1992, 24: 177–179.Google Scholar

Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • A. Simonon
    • 1
  • Ph. Lepage
    • 2
  • E. Karita
    • 1
  • D.-G. Hitimana
    • 2
  • F. Dabis
    • 3
  • Ph. Msellati
    • 3
  • F. Nsemgumuremyi
    • 1
  • Ch. van Goethem
    • 2
  • A. Bazubagira
    • 2
  • Ph. van de Perre
    • 1
  1. 1.National AIDS Control ProgrammeAids Reference LaboratoryKigaliRwanda
  2. 2.Department of PaediatricsCentre Hospitalier de KigaliRwanda
  3. 3.INSERM U330University of Bordeaux IIFrance

Personalised recommendations