Popek EJ, Korber BT, Merritt L, Bardenguez A, Lee A, Hammill HA, Wiznia A, Viscarello R, Luzuriaga K, Van Dyke RB; Conference on Retroviruses and Opportunistic Infections.

Program Abstr 4th Conf Retrovir Oppor Infect Conf Retrovir Oppor Infect 4th 1997 Wash DC. 1997 Jan 22-26; 4th: 158 (abstract no. 504).

Texas Children's Hospital, Houston, TX.

The Ariel study, initiated in 1992 to prospectively study transmission of HIV-1 from mother to infant, enrolled 242 HIV+ pregnant women at 7 sites within the USA. The resultant cohort includes 209 infants with 2 year follow up, of whom 19 are HIV+, a transmission rate of 9%. 187 placentas were evaluated pathologically, without knowledge of the infant's HIV status for: inflammation of the membranes, umbilical cord, villi and decidua, as well as other areas of disruption of the placental barrier. Of the pathologic features evaluated, increased transmission was associated with histologic acute chorioamnionitis. 15/187 placentas were from transmitters; 29/187 had acute chorioamnionitis and of these 6/29 were transmitters. With further stratification for duration of membrane rupture (ROM): ROM of less than 4 hours and no acute chorioamnionitis had 6% transmission, ROM less than 4 hours and acute chorioamnionitis also had 6% transmission; when ROM was greater than or equal to 4 hours in the absence of acute chorioamnionitis transmission remained low at 5%, but when ROM was greater than or equal to 4 hours in the presence of acute chorioamnionitis transmission of HIV-1 was 38%. The correlation between clinical chorioamnionitis and histologic evidence of significant inflammation within the chorioamnion was poor; 23% of placentas showed significant acute inflammation within the chorioamnion with only 8% of these being clinically identified. Early identification of acute inflammation within the placental membranes might direct earlier intervention in HIV-1 + pregnant women with ruptured membranes and should further reduce the transmission rate.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Chorioamnionitis
• Disease Transmission, Vertical
• Female
• HIV Infections
• HIV Seropositivity
• HIV-1
• Humans
• Infant
• Inflammation
• Placenta
• Pregnancy
• Pregnancy Complications
• Umbilical Cord
• transmission

Other ID:

• 97926245

UI: 102223254

From Meeting Abstracts