Maternal viral load and rate of disease progression among vertically HIV-1-infected children: an international meta-analysis

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dc.contributor.authorIoannidis, J. P.en
dc.contributor.authorTatsioni, A.en
dc.contributor.authorAbrams, E. J.en
dc.contributor.authorBulterys, M.en
dc.contributor.authorCoombs, R. W.en
dc.contributor.authorGoedert, J. J.en
dc.contributor.authorKorber, B. T.en
dc.contributor.authorMayaux, M. J.en
dc.contributor.authorMofenson, L. M.en
dc.contributor.authorMoye, J., Jr.en
dc.contributor.authorNewell, M. L.en
dc.contributor.authorShapiro, D. E.en
dc.contributor.authorTeglas, J. P.en
dc.contributor.authorThompson, B.en
dc.contributor.authorWiener, J.en
dc.date.accessioned2015-11-24T19:05:16Z
dc.date.available2015-11-24T19:05:16Z
dc.identifier.issn0269-9370-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/20168
dc.rightsDefault Licence-
dc.subjectAnti-Retroviral Agents/therapeutic useen
dc.subjectCD4 Lymphocyte Counten
dc.subjectDisease Progressionen
dc.subjectFemaleen
dc.subjectHIV Infections/blood/transmission/*virologyen
dc.subject*Hiv-1en
dc.subjectHumansen
dc.subjectInfanten
dc.subjectInfant, Newbornen
dc.subject*Infectious Disease Transmission, Verticalen
dc.subjectMothersen
dc.subjectOdds Ratioen
dc.subjectPrognosisen
dc.subjectProspective Studiesen
dc.subjectRNA, Viral/blooden
dc.subjectViral Load/*methodsen
dc.titleMaternal viral load and rate of disease progression among vertically HIV-1-infected children: an international meta-analysisen
heal.abstractOBJECTIVE: To evaluate whether maternal human immunodeficiency virus type 1 (HIV-1) RNA levels in the serum/plasma of mothers at or close to the time of delivery affects the rate of disease progression among vertically HIV-1-infected children and whether it correlates with other parameters affecting infant disease progression. METHODS: International meta-analysis of eight studies with 574 HIV-1 infected infants with available maternal HIV-1 RNA measurements at or close to delivery and clinical follow-up. The primary outcome was disease progression (stage C disease or death, n = 178). Cohort-stratified Cox models were used. RESULTS: Higher maternal HIV-1 RNA level at or close to delivery significantly increased disease progression risk [hazard ratio (HR), 1.25; 95% confidence interval (CI), 1.04-1.52 per 1 log10 increase; P = 0.02) with a borderline effect on mortality (HR, 1.26; 95% CI, 0.96-1.65; P = 0.10]. The association with disease progression risk was strong in the first 6 months of life (HR, 1.77; 95% CI, 1.28-2.45; P = 0.001), but not subsequently (HR, 1.03; 95% CI, 0.81-1.30). Maternal HIV-1 RNA, early infant HIV-1 RNA (at 30-200 days after birth) and infant CD4 were independent predictors of disease progression in the first 6 months. Maternal HIV-1 RNA at or close to delivery correlated with early infant HIV-1 RNA (r = 0.26, P < 0.001). Effects were independent of maternal and infant treatment. CONCLUSIONS: Higher maternal HIV-1 RNA at or close to delivery strongly predicts disease progression for HIV-1-infected infants, especially in their first 6 months of life and correlates with the early peak of viremia in the infected child.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/15090835-
heal.journalNameAIDSen
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2004-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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