Genetic diversity of HIV-1 in western Kenya: subtype-specific differences in mother-to-child transmission

被引:50
作者
Yang, CF
Li, M
Newman, RD
Shi, YP
Ayisi, J
van Eijk, AM
Otieno, J
Misore, AO
Steketee, RW
Nahlen, BL
Lal, RB
机构
[1] Ctr Dis Control & Prevent, Div AIDS STD & TB Lab Res, Atlanta, GA USA
[2] Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Atlanta, GA USA
[3] Ctr Dis Control & Prevent, Epidemiol Program Off, Div Appl Publ Hlth Training, Atlanta, GA USA
[4] Kenya Govt Med Res Ctr, Ctr Vector Biol & Control Res, Kisumu, Kenya
[5] New Nyanza Provincial Gen Hosp, Minist Hlth, Kisumu, Kenya
[6] WHO, Roll Back Malaria, CH-1211 Geneva, Switzerland
关键词
HIV-1; subtypes; risk factors for HIV-1 transmission; subtype-specific differences; vertical transmission of HIV-1;
D O I
10.1097/00002030-200307250-00011
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background: Little is known about the impact of HIV-1 group M subtypes on mother-to-child transmission (MTCT) of HIV-1 in African settings where multiple HIV-1 group M subtypes are co-circulating. Objective: To assess the role of subtype variation on MTCT. Methods: HIV-1-infected women attending an antenatal clinic in western Kenya were enrolled for a prospective study (1996-2000) of MTCT. HIV-1 subtype analysis of p24gag and gp41env identified potential recombinants, and their role in MTCT was determined. Results: Among 414 women for whom HIV-1 subtype and HIV transmission status were available, MTCT occurred in 80 (19.3%). MTCT rates were higher among women with subtype D compared with subtype A in either the gp41 region [31.6 versus 16.1%, relative risk (RR) 2.0, P = 0.002] or p24 region (29.9 versus 18.0%, RR 1.7, P = 0.02). Discordant subtype combinations were identified in 103 of the women (25.9%), and were associated with higher rates of MTCT (28.2 versus 17.0%, RR 1.7, P = 0.01). In multivariate analysis, women with subtype combinations D/D, D/A, and A/D had an increased risk of MTCT (adjusted odds ratios 3.5, 2.5, 6.2; P=0.005, 0.05, and 0.0003, respectively) compared with A/A women after adjustment for maternal HIV viral load, placental malaria infection, episiotomy or perineal tear, and low birthweight. Conclusion: MTCT appears to be more common among mothers infected with subtype D compared with subtype A. Such differences in MTCT frequency may be caused by altered cellular tropism for placental cell types. (C) 2003 Lippincott Williams Wilkins.
引用
收藏
页码:1667 / 1674
页数:8
相关论文
共 43 条
[1]   Similar rate of disease progression among individuals infected with HIV-1 genetic subtypes A-D [J].
Alaeus, A ;
Lidman, K ;
Björkman, A ;
Giesecke, J ;
Albert, J .
AIDS, 1999, 13 (08) :901-907
[2]   Significance of HIV-1 genetic subtypes [J].
Alaeus, A .
SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES, 2000, 32 (05) :455-463
[3]   Clinical disease associated with HIV-1 subtype B′ and E infection among 2104 patients in Thailand [J].
Amornkul, PN ;
Tansuphasawadikul, S ;
Limpakarnjanarat, K ;
Likanonsakul, S ;
Young, N ;
Eampokalap, B ;
Kaewkungwal, J ;
Naiwatanakul, T ;
Von Bargen, J ;
Hu, DJ ;
Mastro, TD .
AIDS, 1999, 13 (14) :1963-1969
[4]   The effect of dual infection with HIV and malaria on pregnancy outcome in western Kenya [J].
Ayisi, JG ;
van Eijk, AM ;
ter Kuile, FO ;
Kolczak, MS ;
Otieno, JA ;
Misore, AO ;
Kager, PA ;
Steketee, RW ;
Nahlen, BL .
AIDS, 2003, 17 (04) :585-594
[5]   Phenotypic characteristics of human immunodeficiency virus type 1 subtype C isolates of Ethiopian AIDS patients [J].
Björndal, Å ;
Sönnerborg, A ;
Tscherning, C ;
Albert, J ;
Fenyö, EM .
AIDS RESEARCH AND HUMAN RETROVIRUSES, 1999, 15 (07) :647-653
[6]   Human immunodeficiency virus superinfection and recombination: Current state of knowledge and potential clinical consequences [J].
Blackard, JT ;
Cohen, DE ;
Mayer, KH .
CLINICAL INFECTIOUS DISEASES, 2002, 34 (08) :1108-1114
[7]   HIV-1 LTR subtype and perinatal transmission [J].
Blackard, JT ;
Renjifo, B ;
Fawzi, W ;
Hertzmark, E ;
Msamanga, G ;
Mwakagile, D ;
Hunter, D ;
Spiegelman, D ;
Sharghi, N ;
Kagoma, C ;
Essex, M .
VIROLOGY, 2001, 287 (02) :261-265
[8]  
BULTERYS M, 2002, AIDS SCI, V2, P1
[9]   Evaluation of performance of the Gen-Probe human immunodeficiency virus type 1 viral load assay using primary subtype A, C, and D isolates from Kenya [J].
Emery, S ;
Bodrug, S ;
Richardson, BA ;
Giachetti, C ;
Bott, MA ;
Panteleeff, D ;
Jagodzinski, LL ;
Michael, NL ;
Nduati, R ;
Bwayo, J ;
Kreiss, JK ;
Overbaugh, J .
JOURNAL OF CLINICAL MICROBIOLOGY, 2000, 38 (07) :2688-2695
[10]   Impact of human immunodeficiency virus type 1 (HIV-1) subtype on women receiving single-dose nevirapine prophylaxis to prevent HIV-1 vertical transmission (HIV Network for Prevention Trials 012 study) [J].
Eshleman, SH ;
Becker-Pergola, G ;
Deseyve, M ;
Guay, LA ;
Mracna, M ;
Fleming, T ;
Cunningham, S ;
Musoke, P ;
Mmiro, F ;
Jackson, JB .
JOURNAL OF INFECTIOUS DISEASES, 2001, 184 (07) :914-917