Da. Katzenstein et al., Serum level of maternal human immunodeficiency virus (HIV) RNA, infant mortality, and vertical transmission of HIV in Zimbabwe, J INFEC DIS, 179(6), 1999, pp. 1382-1387
Maternal human immunodeficiency virus (HIV) RNA load, vertical transmission
of subtype C HIV, and infant mortality were examined in 251 HIV-seropositi
ve women and their infants in Zimbabwe. Demographic characteristics, health
and medical histories, serum HIV RNA loads, and CD4(+) lymphocyte counts f
or mothers were examined by logistic regression analysis to determine signi
ficant risk factors and their odds ratios for transmission and infant morta
lity. Tenfold (1 log(10)) incremental increases in maternal HIV RNA were as
sociated with a 1.9-fold increase (95% confidence interval [CI], 1.2-2.9) i
n transmission and a 2.1-fold increase (95% CI, 1.3-3.5) in infant mortalit
y (P <.01). Maternal CD4 cell counts and demographic and medical characteri
stics were not significant predictors of transmission, However, maternal CD
4 cell counts below the median (400/mm(3)) were significantly associated wi
th infant mortality (P=.035, Fisher's exact test). The maternal level of se
rum HIV is an important determinant of vertical transmission and infant mor
tality in subtype C infection In Zimbabwe.