Msamanga Gernard I, Taha Taha E, Young Alicia M, Brown Elizabeth R, Hoffman Irving F, Read Jennifer S, Mudenda Victor, Goldenberg Robert L, Sharma Usha, Sinkala Moses, Fawzi Wafaie W
Department of Community Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Am J Trop Med Hyg. 2009 Apr;80(4):508-15.
There are few studies of the association between placental malaria (PM) and mother-to-child transmission (MTCT) of human immunodeficiency virus-1 (HIV-1), and the results of published studies are inconsistent. To determine the association between PM and MTCT of HIV-1, we performed a secondary analysis of data from a clinical trial of antibiotics to reduce chorioamnionitis. Data regarding 1,662 HIV-1-infected women with live born singleton and first-born twin infants with information regarding PM and infant HIV-1 infection status at birth were analyzed. At the time of the study, women did not have access to antiretroviral drugs for treatment of acquired immunodeficiency syndrome but had received nevirapine prophylaxis to reduce the risk of MTCT of HIV-1. Placental malaria was not associated with the infant HIV-1 infection status at birth (P = 0.67). Adjustment for maternal plasma viral load and CD4+ cell count did not change these results (odds ratio = 1.06, 95% confidence interval = 0.51-2.20, P = 0.87). Placental malaria was more likely to be related to HIV-1 infection at birth among women with low viral load at baseline (P for interaction = 0.08). In conclusion, PM was not associated with infant HIV-1 infection status at birth. The interaction of maternal plasma viral load, PM, and MTCT of HIV-1 warrants further studies.
关于胎盘疟疾（PM）与人类免疫缺陷病毒1型（HIV-1）母婴传播（MTCT）之间关联的研究较少，且已发表研究的结果并不一致。为了确定PM与HIV-1母婴传播之间的关联，我们对一项抗生素降低绒毛膜羊膜炎临床试验的数据进行了二次分析。分析了1662名感染HIV-1且单胎活产或双胎头胎出生的妇女的数据，这些数据包含PM及婴儿出生时HIV-1感染状况的信息。在研究期间，妇女无法获得用于治疗获得性免疫缺陷综合征的抗逆转录病毒药物，但接受了奈韦拉平预防以降低HIV-1母婴传播的风险。胎盘疟疾与婴儿出生时的HIV-1感染状况无关（P = 0.67）。对母亲血浆病毒载量和CD4 +细胞计数进行校正后，这些结果未改变（比值比 = 1.06，95%置信区间 = 0.51 - 2.20，P = 0.87）。在基线病毒载量较低的妇女中，胎盘疟疾更可能与出生时的HIV-1感染有关（交互作用P = 0.08）。总之，胎盘疟疾与婴儿出生时的HIV-1感染状况无关。母亲血浆病毒载量、胎盘疟疾和HIV-1母婴传播之间的相互作用值得进一步研究。
