The Ariel project: A prospective cohort study of maternal-child transmission of human immunodeficiency virus type 1 in the era of maternal antiretroviral therapy

Russell B. Van Dyke*, Bette T. Korber, Edwina Popek, Catherine Macken, Susan M. Widmayer, Arlene Bardeguez, I. Celine Hanson, Andrew Wiznia, Katherine Luzuriaga, Richard R. Viscarello, Steven Wolinsky, Arthur Ammann, Irvin Chen, April Gifford, David Ho, Richard A. Koup, Paul Krogstad, Mark Muldoon, James Mulins, Bruce Walker

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

87 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)319-328
Number of pages10
JournalJournal of Infectious Diseases
Volume179
Issue number2
DOIs
StatePublished - 1999

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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