Sexually 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.
Urine 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.
Of 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.
This 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.
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By:
- 1From the *David Geffen UCLA School of Medicine, Los Angeles, CA; †Fielding School of Public Health, UCLA, Los Angeles, CA; ‡Westat, Rockville, MD; §Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil; ¶Office of the Global AIDS Coordinator, US Department of State, Washington, DC; ∥Cepheid, Sunnyvale, CA; **Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD; ††Hospital Geral de Nova Iguaçu, Nova Iguaçu, RJ, Brazil; and ‡‡Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, Brazil.
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