David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Am J Trop Med Hyg. 2011 Aug;85(2):202-6. doi: 10.4269/ajtmh.2011.10-0589.
We conducted a nested case-control study of placental malaria (PM) and mother-to-child transmission (MTCT) of human immunodeficiency virus-1 (HIV-1) within a prospective cohort of 627 mother-infant pairs followed from October 1989 until April 1994 in rural Rwanda. Sixty stored placentas were examined for PM and other placental pathology, comparing 20 HIV-infected mother-infant (perinatal transmitter) pairs, 20 HIV-uninfected pairs, and 20 HIV-infected mothers who did not transmit to their infant perinatally. Of 60 placentas examined, 45% showed evidence of PM. Placental malaria was associated with increased risk of MTCT of HIV-1 (adjusted odds ratio [aOR] = 6.3; 95% confidence interval [CI] = 1.4-29.1), especially among primigravidae (aOR = 12.0; 95% CI = 1.0-150; P < 0.05). Before antiretroviral therapy or prophylaxis, PM was associated with early infant HIV infection among rural Rwandan women living in a hyper-endemic malaria region. Primigravidae, among whom malaria tends to be most severe, may be at higher risk.
我们在卢旺达农村进行了一项嵌套病例对照研究，在 1989 年 10 月至 1994 年 4 月期间对 627 对母婴进行了前瞻性队列研究，以研究胎盘疟疾 (PM) 和人类免疫缺陷病毒 1 (HIV-1) 的母婴垂直传播 (MTCT)。对 60 个储存胎盘进行了检查，以研究 PM 和其他胎盘病理学，比较了 20 对 HIV 感染的母婴 (围产期传播者) 对、20 对 HIV 未感染的母婴对和 20 对 HIV 感染但未在围产期将病毒传播给婴儿的母婴对。在检查的 60 个胎盘中有 45% 显示出 PM 的证据。PM 与 HIV-1 的 MTCT 风险增加相关（调整后的优势比[aOR]=6.3；95%置信区间[CI]=1.4-29.1），尤其是在初产妇中（aOR=12.0；95%CI=1.0-150；P<0.05）。在抗逆转录病毒治疗或预防之前，PM 与居住在高度流行疟疾地区的卢旺达农村妇女的婴儿早期 HIV 感染有关。初产妇中，疟疾往往最为严重，她们的风险可能更高。
