Maternal Malaria and Perinatal HIV Transmission, Western Kenya1,2

• DOI: 10.3201/eid1004.030303
• Publication Date: 2012-05-15T13:34:04Z
• Authors: John G. Ayisi; Anna M. van Eijk; Robert D. Newman; Feiko O. ter Kuile; Ya Ping Shi; Chunfu Yang; Margarette S. Kol...; Juliana A. Otieno; Ambrose O. Misore; Piet A. Kager; Renu B. Lal; Richard W. Steketee; Bernard L. Nahlen
• Keywords: placenta; malaria; HIV Infections; Infectious and parasitic diseases; RC109-216; 03 medical and health sciences; 0302 clinical medicine; Pregnancy; Risk Factors; risk factors; Humans; vertical disease transmission; Research; R; Infant, Newborn; HIV; Infectious Disease Transmission, Vertical; Malaria; 3. Good health; Pregnancy Complications, Parasitic; Multivariate Analysis; Medicine; Female; pregnancy

Abstract To determine whether maternal placental malaria is associated with an increased risk for perinatal mother-to-child HIV transmission (MTCT), we studied HIV-positive women in western Kenya. We enrolled 512 mother-infant pairs; 128 (25.0%) had malaria, and 102 (19.9%) infants acquired perinatally. Log10 viral load episiotomy or perineal tear were transmission, whereas low-density (<10,000 parasites/μL) was reduced (adjusted relative [ARR] 0.4). Among dually infected HIV, high-density (>10,000 MTCT (ARR 2.0), compared to malaria. The interaction between appears be variable complex: that controlled at low density may cause increase broad-based immune responses protect against MTCT; uncontrolled, simultaneously disrupt architecture generate substantial antigen stimulus replication MTCT.