Table 3. Relationship of Infant HIV transmission with risk factors.
| Infant HIV Positive (N = 82) |
Infant HIV Negative (N = 817) |
Unadjusted | Adjusted | |||
|---|---|---|---|---|---|---|
| n (row %) | n (row %) | OR (95% CI) | p-value | OR (95% CI) | p-value | |
|
Maternal CMV (CMV viruria) |
||||||
| Detected | 7 (30.4) | 16 (69.6) | 4.84 (1.77–13.21) | 0.002 | 4.44 (1.51–13.0) | 0.01 |
| Missing | 56 (8.7) | 591 (91.3) | 1.05 (0.61–1.80) | 0.87 | 0.96 (0.54–1.70) | 0.89 |
| Not detected | 19 (8.3) | 210 (91.7) | 1.00 | 1.00 | ||
| Parent HPTN 040 Study arm | ||||||
| ZDV | 37 (12.2) | 267 (87.8) | 1.00 | 1.00 | ||
| ZDV+NVP | 22 (7.2) | 285 (92.8) | 0.56 (0.32–0.97) | 0.04 | 0.52 (0.29–0.94) | 0.03 |
| ZDV+3TC+NFV | 23 (8.0) | 265 (92.0) | 0.63 (0.36–1.08) | 0.09 | 0.61 (0.34–1.09) | 0.09 |
| Maternal age (years) | ||||||
| 13–24 | 36 (9.6) | 340 (90.4) | 0.96 (0.57–1.62) | 0.87 | ||
| 25–29 | 19 (7.5) | 233 (92.5) | 0.74 (0.40–1.36) | 0.33 | ||
| 30 and older | 27 (10.0) | 244 (90.0) | 1.00 | |||
|
Maternal HIV viral load, Categorical (copies/mL) |
||||||
| ≤400 | 2 (3.8) | 50 (96.2) | 1.00 | |||
| 401 to ≤ 10,000 | 19 (5.9) | 303 (94.1) | 1.57 (0.35–6.94) | 0.55 | ||
| 10,001 to 100,000 | 41 (9.8) | 377 (90.2) | 2.72 (0.64–11.59) | 0.18 | ||
| >100,000 | 20 (19.2) | 84 (80.8) | 5.95 (1.33–26.55) | 0.02 | ||
| Region | ||||||
| Americas | 73 (9.4) | 702 (90.6) | 1.00 | |||
| South Africa | 9 (7.3) | 115 (92.7) | 0.75 (0.37–1.55) | 0.44 | ||
| Mode of delivery | ||||||
| Cesarean before rupture | 19 (7.7) | 227 (92.3) | 0.78 (0.46–1.34) | 0.37 | ||
| Vaginal + CS after rupture | 63 (9.6) | 590 (90.4) | 1.00 | |||
| Maternal syphilis (TP) | ||||||
| No | 74 (9.0) | 747 (91.0) | 1.00 | |||
| Yes | 8 (10.3) | 70 (89.7) | 1.15 (0.53–2.49) | 0.72 | ||
| Maternal chlamydia (CT) or gonorrhea (NG) | ||||||
| No | 62 (8.5) | 664 (91.5) | 1.00 | |||
| Yes | 20 (11.6) | 153 (88.4) | 1.40 (0.82–2.39) | 0.22 | ||
| Maternal chlamydia (CT) | ||||||
| No | 62 (8.4) | 677 (91.6) | 1.00 | |||
| Yes | 20 (12.5) | 140 (87.5) | 1.56 (0.91–2.67) | 0.10 | ||
| Maternal gonorrhea (NG) | ||||||
| No | 78 (9.0) | 785 (91.0) | 1.00 | |||
| Yes | 4 (11.1) | 32 (88.9) | 1.26 (0.43–3.65) | 0.67 | ||
| CMV (Infant Congenital CMV; cCMV) | ||||||
| No | 67 (8.0) | 775 (92.0) | 1.00 | |||
| Yes | 15 (26.3) | 42 (73.7) | 4.13 (2.18–7.84) | < .0001 | ||
| Any STI (maternal TP, CT, NG or cCMV positive) | ||||||
| No | 47 (7.5) | 579 (92.5) | 1.00 | 1.00 | ||
| Yes | 35 (12.8) | 238 (87.2) | 1.81 (1.14–2.88) | 0.01 | 1.85 (1.13–3.02) | 0.01 |
|
Subjects with 0, 1, 2, 3, 4 STIs |
||||||
| 0 STI | 47 (7.5) | 579 (92.5) | 1.00 | |||
| 1 STI | 24 (10.8) | 199 (89.2) | 1.49 (0.89–2.49) | 0.13 | 1.57 (0.91–2.71) | 0.11 |
| 2 STIs | 10 (23.8) | 32 (76.2) | 3.85 (1.78–8.31) | 0.001 | 3.44 (1.53–7.74) | 0.003 |
| 3 STIs | 1 (12.5) | 7 (87.5) | 1.76 (0.21–14.61) | 0.60 | 1.12 (0.13–10.1) | 0.92 |
| Prenatal Care | ||||||
| No | 22 (8.1) | 251 (91.9) | 1.00 | |||
| Yes | 60 (9.6) | 564 (90.4) | 1.21 (0.73–2.02) | 0.46 | ||
|
Time (hours) of membrane Rupture prior to Delivery |
||||||
| Unknown | 7 (7.5) | 86 (92.5) | 1.00 (0.43–2.32) | 1.00 | ||
| >24 | 5 (20.0) | 20 (80.0) | 3.07 (1.09–8.66) | 0.03 | ||
| 12–24 | 8 (19.0) | 34 (81.0) | 2.89 (1.25–6.71) | 0.01 | ||
| 6-<12 | 6 (8.7) | 63 (91.3) | 1.17 (0.47–2.89) | 0.73 | ||
| .5-<6 | 20 (10.4) | 172 (89.6) | 1.43 (0.80–2.54) | 0.22 | ||
| 0.5 | 36 (7.5) | 442 (92.5) | 1.00 | |||
| Alcohol use during pregnancy | ||||||
| > = 1/week | 17 (12.2) | 122 (87.8) | 1.38 (0.77–2.47) | 0.28 | ||
| >1/month, <1/week | 5 (7.8) | 59 (92.2) | 0.84 (0.32–2.18) | 0.72 | ||
| ≤1/month | 7 (5.7) | 116 (94.3) | 0.60 (0.26–1.35) | 0.21 | ||
| Never | 52 (9.2) | 514 (90.8) | 1.00 | |||
|
Illegal substance use during pregnancy |
||||||
| Yes | 13 (14.8) | 75 (85.2) | 1.85 (0.98–3.51) | 0.06 | 2.32 (1.16–4.64) | 0.02 |
| No | 69 (8.6) | 738 (91.4) | 1.00 | 1.00 | ||
| Infant death | ||||||
| No | 73 (8.3) | 806 (91.7) | 1.00 | 1.00 | ||
| Yes | 9 (45.0) | 11 (55.0) | 9.04 (3.63–22.52) | < .0001 | 7.14 (2.71–18.8) | 0.0001 |
|
Maternal CD4+ count (cells/mm3)/100 |
82 (9.3) | 803 (90.7) | 0.90 (0.82–0.98) | 0.02 | ||
| Log10 of maternal HIV viral load | 82 (9.2) | 814 (90.8) | 1.88 (1.40–2.53) | < .0001 | 1.85 (1.35–2.53) | 0.0001 |
Abbreviations: 3TC = lamivudine; CI, confidence interval; CMV, cytomegalovirus; cCMV = congenital CMV infection CS = Cesarean section; CT = Chlamydia trachomatis; HIV, human immunodeficiency virus; NFV = nelfinavir; NG = Neisseria gonorrhoeae; NVP = nevirapine; OR, odds ratio; SD, standard deviation; STI = sexually transmitted infection; ZDV = zidovudine.