Retrospective study of maternal HIV-1 and HIV-2 infections and child survival in Abidjan, Côte d'Ivoire
De Cock, K.M.; Zadi, F.; Adjorlolo, G.; Diallo, M.O.; Sassan-Morokro, M.; Ekpini, E.; Sibailly, T.; Doorly, R.; Batter, V.; Brattegaard, K.
Bmj 308(6926): 441-443
1994
ISSN/ISBN: 0959-8138 PMID: 8124173 DOI: 10.1016/0020-7292(94)90390-5Document Number: 277535
Objectives-To compare the effects of maternal HIV-1 and HIV-2 infections on outcome of pregnancy, infant mortality, and child survival, and to measure serological concordance between mothers and children. Design-Retrospective cohort study with cross sectional study of concordance for HIV antibodies. Setting-Hospital, tuberculosis clinic, and maternal and child health centre in Abidjan, Cote d'Ivoire, west Africa. Subjects-986 women who had a total of 2758 pregnancies since 1980. The last born children of 194 of these women. Main outcome measures-Pregnancy outcomes; mortality for all children born since 1980; and outcome for last born children. Serological concordance between mothers and last born children. Results-Woman with HIV-1 and HIV-2 infections had higher rates of spontaneous abortion and stillbirth than uninfected women (86/769 in HIV-1 positive women, 48/421 in HIV-2 positive, 31/234 in dually reactive, and 96/1131 in uninfected). Compared with children born to uninfected mothers (mortality 10.3%), greater proportions of children of HIV-1 positive (20.6%) and dually reactive (20.3%) mothers had died; mortality in children of HIV-2 infected women (13.1%) was not significantly increased. Infant mortalities for the last born children of HIV-1 positive, dually reactive, HIV-2 positive, and seronegative women were, respectively, 133, 82, 32, and 40 per 1000 live births. Nine of 77 last born children of HIV-1 positive mothers were concordantly seropositive compared with none of 21 children of HIV-2 infected mothers. Conclusions-Maternal HIV-2 infection has less influence on child survival than infection with HIV-1, probably because of a lower vertical transmission rate.