Journal Article

Chlamydia and Gonorrhea in HIV-Infected Pregnant Women and Infant HIV Transmission

Weir, Fred, Persing, David, Klausner, Jeffrey D., Xu, Jiahong, Pilotto, Jose Henrique, Watts, D. Heather, Joao, Esau, Nielsen-Saines, Karin, Morgado, Mariza G., Mofenson, Lynne M., Veloso, Valdilea G., Bristow, Claire C., Adachi, Kristina, Ank, Bonnie

2015

Overview

BACKGROUNDSexually transmitted infections (STIs) such as Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) can lead to adverse pregnancy and neonatal outcomes. The prevalence of STIs and its association with HIV mother-to-child transmission (MTCT) were evaluated in a substudy analysis from a randomized, multicenter clinical trial. METHODOLOGYUrine samples from HIV-infected pregnant women collected at the time of labor and delivery were tested using polymerase chain reaction testing for the detection of CT and NG (Xpert CT/NG; Cepheid, Sunnyvale, CA). Infant HIV infection was determined by HIV DNA polymerase chain reaction at 3 months. RESULTSOf the 1373 urine specimens, 249 (18.1%) were positive for CT and 63 (4.6%) for NG; 35 (2.5%) had both CT and NG detected. Among 117 cases of HIV MTCT (8.5% transmission), the lowest transmission rate occurred among infants born to CT- and NG-uninfected mothers (8.1%) as compared with those infected with only CT (10.7%) and both CT and NG (14.3%; P = 0.04). Infants born to CT-infected mothers had almost a 1.5-fold increased risk for HIV acquisition (odds ratio, 1.47; 95% confidence interval, 0.9–2.3; P = 0.09). CONCLUSIONSThis cohort of HIV-infected pregnant women is at high risk for infection with CT and NG. Analysis suggests that STIs may predispose to an increased HIV MTCT risk in this high-risk cohort of HIV-infected women.

• Publisher: Lippincott Williams & Wilkins, a business of Wolters Kluwer Health,Copyright American Sexually Transmitted Diseases Association,Lippincott Williams & Wilkins Ovid Technologies
• Subject: Adult / Argentina - epidemiology / Brazil - epidemiology / Chemical analysis / Chlamydia / Chlamydia Infections - immunology / Chlamydia Infections - prevention & control / Chlamydia Infections - transmission / Chlamydia trachomatis / Clinical research / Clinical trials / Deoxyribonucleic acid / Disease transmission / DNA / Female / Gonorrhea / Gonorrhea - immunology / Gonorrhea - prevention & control / Gonorrhea - transmission / High risk / HIV / HIV Seropositivity - complications / HIV Seropositivity - immunology / HIV Seropositivity - transmission / Human immunodeficiency virus / Humans / Infant / Infants / Infections / Infectious Disease Transmission, Vertical - prevention & control / Maternal & child health / Mothers / Neisseria gonorrhoeae / Obstetrics / Original Study / Polymerase chain reaction / Post-Exposure Prophylaxis / Pregnancy / Pregnancy Complications, Infectious - prevention & control / Pregnant People / Prevalence / Risk / Risk Factors / Sexually transmitted diseases / South Africa - epidemiology / STD / United States - epidemiology / Urine tests / Women