Van Dyke R B, Korber B T, Popek E, Macken C, Widmayer S M, Bardeguez A, Hanson I C, Wiznia A, Luzuriaga K, Viscarello R R, Wolinsky S
Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA 70112, USA.
J Infect Dis. 1999 Feb;179(2):319-28. doi: 10.1086/314580.
In a prospective cohort study, clinical and biologic factors that contribute to maternal-child transmission of human immunodeficiency virus type 1 (HIV-1) were studied. HIV-infected pregnant women and their infants were evaluated prospectively according to a standardized protocol. Of 204 evaluable women, 81% received zidovudine during their pregnancy. The infection rate among the 209 evaluable infants was 9.1%. By univariate analysis, histologic chorioamnionitis, prolonged rupture of membranes, and a history of genital warts were significantly associated with transmission. Additional factors associated with transmission that approached significance included a higher maternal virus load at delivery and the presence of cocaine in the urine. In a logistic regression model, histologic chorioamnionitis was the only independent predictor of transmission. Despite a significantly higher transmission rate at one site, no unique viral genotype was found at any site. Thus, chorioamnionitis was found to be the major risk factor for transmission among women receiving zidovudine.
在一项前瞻性队列研究中，对导致1型人类免疫缺陷病毒（HIV-1）母婴传播的临床和生物学因素进行了研究。根据标准化方案对感染HIV的孕妇及其婴儿进行前瞻性评估。在204名可评估的妇女中，81%在孕期接受了齐多夫定治疗。209名可评估婴儿中的感染率为9.1%。单因素分析显示，组织学绒毛膜羊膜炎、胎膜早破和尖锐湿疣病史与传播显著相关。接近显著水平的与传播相关的其他因素包括分娩时产妇病毒载量较高以及尿液中存在可卡因。在逻辑回归模型中，组织学绒毛膜羊膜炎是传播的唯一独立预测因素。尽管在一个地点传播率显著较高，但在任何地点均未发现独特的病毒基因型。因此，绒毛膜羊膜炎被发现是接受齐多夫定治疗的妇女中传播的主要危险因素。
