Maternal HLA homozygosity and mother-child HLA concordance increase the risk of vertical transmission of HIV-1.
Date
2008-04Author
Mackelprang, RD
John-Stewart, G
Carrington, M
Richardson, B
Rowland-Jones, S
Gao, X
Mbori-Ngacha, DA
Mabuka, J
Lohman-Payne, B
Farquhar, C
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
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]; P = .04 in utero (adjusted odds ratio, 1.72 [95% CI, 1.0-1.7]; P = .04), and via breast-feeding (aHR, 1.6 [95% CI, 1.0-2.5]; P = .04). Women with homozygosity had higher plasma HIV-1 RNA levels at 32 weeks of gestation (5.1 vs. 4.8 log(10) copies/mL; P = .03) and an increased risk of transmission overall (aHR, 1.7 [95% CI, 1.1-2.7]; P = .03) and via breast-feeding (aHR, 5.8 [95% CI, 1.9-17.7]; P = .002).
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.
URI
http://www.ncbi.nlm.nih.gov/pubmed/18462163http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/30709
Citation
J Infect Dis. 2008 Apr 15;197(8):1156-61Publisher
University of Nairobi. Department of Paediatrics and Child Health, Univeristy of Nairobi, Kenya Department of Epidemiology, University of Washington, Seattle 98104, USA.
Collections
- Faculty of Health Sciences (FHS) [10377]