MATERNAL HIV-1 RNA SERUM LEVELS AT DELIVERY AND VERTICAL TRANSMISSIONIN UGANDA

Objective. To evaluate the clinical utility of maternal HIV-1 RNA seru m levels at delivery in predicting the rate of HIV-1 vertical transmis sion. Design and Methods. HIV-1 RNA levels were determined by the Roch e Amplicor Monitor assay in serum specimens collected at the time of d elivery from 94 transmitting and 107 nontransmitting infected mothers and 12 seronegative mothers in Uganda, Nonparametric Wilcoxon-Rank sum tests were used to identify significant differences in medians and RN A level distributions by transmission status. Results. Mean HIV-1 RNA copies/mL for transmitters was 3419 +/- 7489 copies/mL versus 2483 +/- 8954 copies/mL for nontransmitters. There was a significant differenc e in medians and HIV-1 RNA serum level distributions between transmitt ing and nontransmitting mothers (p = 0.0039). However, the predictive value for any given HIV-1 RNA level for HIV-1 vertical transmission wa s poor. Conclusion. Maternal HIV-1 RNA serum levels at delivery are si gnificantly higher in transmitting mothers versus nontransmitting moth ers, but appear to he of limited value in predicting HIV-1 vertical tr ansmission using the Roche Amplicor Monitor assay in Uganda.