PMID- 18462163
OWN - NLM
STAT- MEDLINE
DCOM- 20080605
LR  - 20211020
IS  - 0022-1899 (Print)
IS  - 1537-6613 (Electronic)
IS  - 0022-1899 (Linking)
VI  - 197
IP  - 8
DP  - 2008 Apr 15
TI  - Maternal HLA homozygosity and mother-child HLA concordance increase the risk of 
      vertical transmission of HIV-1.
PG  - 1156-61
LID - 10.1086/529528 [doi]
AB  - 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.
FAU - Mackelprang, Romel D
AU  - Mackelprang RD
AD  - Department of Epidemiology, University of Washington, Seattle 98104, USA.
FAU - John-Stewart, Grace
AU  - John-Stewart G
FAU - Carrington, Mary
AU  - Carrington M
FAU - Richardson, Barbra
AU  - Richardson B
FAU - Rowland-Jones, Sarah
AU  - Rowland-Jones S
FAU - Gao, Xiaojiang
AU  - Gao X
FAU - Mbori-Ngacha, Dorothy
AU  - Mbori-Ngacha D
FAU - Mabuka, Jennifer
AU  - Mabuka J
FAU - Lohman-Payne, Barbara
AU  - Lohman-Payne B
FAU - Farquhar, Carey
AU  - Farquhar C
LA  - eng
GR  - K24 HD054314-03/HD/NICHD NIH HHS/United States
GR  - HD23412/HD/NICHD NIH HHS/United States
GR  - D43 TW000007/TW/FIC NIH HHS/United States
GR  - K24 HD054314/HD/NICHD NIH HHS/United States
GR  - ImNIH/Intramural NIH HHS/United States
GR  - K23 HD041879/HD/NICHD NIH HHS/United States
GR  - N01-CO-12400/CO/NCI NIH HHS/United States
GR  - K23 HD41879/HD/NICHD NIH HHS/United States
GR  - R01 HD023412-15/HD/NICHD NIH HHS/United States
GR  - K01 TW006080/TW/FIC NIH HHS/United States
GR  - R01 HD023412/HD/NICHD NIH HHS/United States
GR  - KO1 TW06080/TW/FIC NIH HHS/United States
GR  - N01 CO012400/CO/NCI NIH HHS/United States
GR  - P30 AI027757/AI/NIAID NIH HHS/United States
GR  - N01CO12400/CA/NCI NIH HHS/United States
GR  - MC_U137884180/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, N.I.H., Intramural
PL  - United States
TA  - J Infect Dis
JT  - The Journal of infectious diseases
JID - 0413675
RN  - 0 (DNA, Viral)
RN  - 0 (HLA Antigens)
RN  - 0 (RNA, Viral)
SB  - IM
MH  - Breast Feeding
MH  - Cohort Studies
MH  - DNA, Viral/blood
MH  - Female
MH  - HIV Infections/genetics/*immunology/*transmission/virology
MH  - HIV-1/*immunology
MH  - HLA Antigens/genetics/*immunology
MH  - Homozygote
MH  - Humans
MH  - Infant, Newborn
MH  - *Infectious Disease Transmission, Vertical
MH  - Milk, Human/virology
MH  - Polymerase Chain Reaction
MH  - Pregnancy
MH  - Pregnancy Complications, Infectious/genetics/*immunology/*virology
MH  - Proportional Hazards Models
MH  - RNA, Viral/blood
PMC - PMC2689391
MID - NIHMS102045
EDAT- 2008/05/09 09:00
MHDA- 2008/06/06 09:00
PMCR- 2009/06/02
CRDT- 2008/05/09 09:00
PHST- 2008/05/09 09:00 [pubmed]
PHST- 2008/06/06 09:00 [medline]
PHST- 2008/05/09 09:00 [entrez]
PHST- 2009/06/02 00:00 [pmc-release]
AID - 10.1086/529528 [doi]
PST - ppublish
SO  - J Infect Dis. 2008 Apr 15;197(8):1156-61. doi: 10.1086/529528.