Interventions to prevent vertical transmission of HIV-1: effect on viral detection rate in early infant samples

摘要: Objective To determine whether mode of delivery or the use maternal neonatal antiretroviral prophylaxis influence age when HIV-1 can first be detected in infected infants, particularly probability detection at birth. Methods In a collaboration between four multicentre studies, data on 422 infants who were assessed by DNA PCR cell culture before 14 days analysed. Weibull mixture models used to estimate cumulative proportion with detectable levels according maternal/neonatal therapy (mainly zidovudine monotherapy) and delivery. Results was 162 (38%) they tested, median 2 days. At birth, it estimated that 36% [95% confidence interval (CI), 31–41%] have virus culture. This percentage not associated either (35% for vaginal versus 40% cesarean section delivery;P  = 0.4) prophylaxis. Among undetectable time viral detectability 14.8 (95% CI, 12.9–16.8 days). increased 15% −11 48%;P  = 0.3) among exposed postnatally compared exposed. No effect observed Conclusions The outcome an early virological test is thought related directly timing transmission primarily reduces risk intrapartum transmission. absence association birth therefore unexpected. There no evidence foetal exposure prophylactic delays substantially diagnosis infection, although this cannot inferred combination therapy.