Maternal HLA homozygosity and mother-child HLA concordance increase the risk of vertical transmission of HIV-1. J Infect Dis . 2008 Apr 15; 197 ( 8 ): 1156-61 . PMID: 18462163 [PubMed - indexed for MEDLINE] Mackelprang RD, John-Stewart G, Carrington M, Ri

Citation:
MBORI- PROFNGACHADOROTHYA. "Maternal HLA homozygosity and mother-child HLA concordance increase the risk of vertical transmission of HIV-1. J Infect Dis . 2008 Apr 15; 197 ( 8 ): 1156-61 . PMID: 18462163 [PubMed - indexed for MEDLINE] Mackelprang RD, John-Stewart G, Carrington M, Ri.". In: J Infect Dis . 2008 Apr 15; 197 ( 8 ): 1156-61 . Earthscan, London. 978-1-84407-469-3 (*); 2008.

Abstract:

Department of Epidemiology, University of Washington, Seattle 98104, USA.
BACKGROUND: Mother-child human leukocyte antigen (HLA) concordance and maternal HLA homozygosity may increase the risk of vertical transmission of human immunodeficiency virus type 1 (HIV-1) risk by reducing infant immune responses. METHODS: We analyzed mother-child HLA concordance and maternal HLA homozygosity in a Kenyan perinatal cohort receiving antenatal zidovudine. HLA concordance was scored as the number of shared class I alleles, and relative risk estimates were adjusted for maternal HIV-1 load. RESULTS: Among 277 mother-infant pairs, HIV-1 transmission occurred in 58 infants (21%), with in utero transmission in 21 (36%), peripartum transmission in 26 (45%), and transmission via breast-feeding in 11 (19%). With increased concordance, we observed a significant increase in the risk of transmission overall (adjusted hazard ratio [aHR], 1.3 [95% confidence interval {CI}, 1.0-1.7]; [Formula: see text]), in utero (adjusted odds ratio, 1.72 [95% CI, 1.0-1.7]; [Formula: see text]), and via breast-feeding (aHR, 1.6 [95% CI, 1.0-2.5]; [Formula: see text]). Women with homozygosity had higher plasma HIV-1 RNA levels at 32 weeks of gestation (5.1 vs. 4.8 log(10) copies/mL; [Formula: see text]) and an increased risk of transmission overall (aHR, 1.7 [95% CI, 1.1-2.7]; [Formula: see text]) and via breast-feeding (aHR, 5.8 [95% CI, 1.9-17.7]; [Formula: see text]). CONCLUSION: The risks of overall, in utero, and breast milk HIV-1 transmission increased with HLA concordance and homozygosity. The increased risk may be due to reduced alloimmunity or less diverse protective immune responses.
PMID: 18462163 [PubMed - indexed for MEDLINE]

Notes:

n/a

Website

UoN Websites Search