Chlamydia trachomatis and Neisseria gonorrhoeae in HIV-infected Pregnant Women and Adverse Infant Outcomes
Identifieur interne : 000901 ( Pmc/Checkpoint ); précédent : 000900; suivant : 000902Chlamydia trachomatis and Neisseria gonorrhoeae in HIV-infected Pregnant Women and Adverse Infant Outcomes
Auteurs : Kristina Adachi [États-Unis] ; Jeffrey D. Klausner [États-Unis] ; Jiahong Xu [États-Unis] ; Bonnie Ank [États-Unis] ; Claire C. Bristow [États-Unis] ; Mariza G. Morgado [Brésil] ; D. Heather Watts [États-Unis] ; Fred Weir [États-Unis] ; David Persing [États-Unis] ; Lynne M. Mofenson [États-Unis] ; Valdilea G. Veloso [Brésil] ; Jose Henrique Pilotto [Brésil] ; Esau Joao [Brésil] ; Glenda Gray [Afrique du Sud] ; Gerhard Theron [Afrique du Sud] ; Breno Santos [Brésil] ; Rosana Fonseca [Brésil] ; Regis Kreitchmann [Brésil] ; Jorge Pinto [Brésil] ; Marisa M. Mussi-Pinhata [Brésil] ; Mariana Ceriotto [Argentine] ; Daisy Maria Machado [Brésil] ; Yvonne J. Bryson [États-Unis] ; Beatriz Grinsztejn [Brésil] ; Francisco I. Bastos [Brésil] ; George Siberry [États-Unis] ; Karin Nielsen-Saines [États-Unis]Source :
- The Pediatric infectious disease journal [ 0891-3668 ] ; 2016.
Abstract
Sexually transmitted infections (STIs) in pregnancy such as
Individual urine specimens from HIV-infected pregnant women diagnosed with HIV during labor were collected at the time of infant birth and tested by polymerase chain reaction for CT and NG. Infant HIV infection was determined at 3 months with morbidity/mortality assessed through 6 months.
Of 1373 maternal urines, 277 (20.2%) were positive for CT and/or NG; 249 (18.1%) for CT, 63 (4.6%) for NG, and 35 (2.5%) for both CT and NG. HIV infection was diagnosed in 117 (8.5%) infants. Highest rates of adverse outcomes (sepsis, pneumonia, congenital syphilis, septic arthritis, conjunctivitis, low birth weight, preterm delivery, death) were noted in infants of women with CT and NG (23/35, 65.7%) compared to NG (16/28, 57.1%), CT (84/214, 39.3%), and no STI (405/1096, 37%, p=0.001). Death (11.4% vs. 3%, p=0.02), low birth weight (42.9% vs. 16.9%, p=0.001), and preterm delivery (28.6% vs. 10.2%, p=0.008) were higher among infants of CT and NG co-infected women. Infants who had any adverse outcome and were born to women with CT and/or NG were 3.5 times more likely to be HIV-infected after controlling for maternal syphilis (OR 3.5, 95% CI 1.4-8.3). By adjusted multivariate logistic regression, infants born to mothers with any CT and/or NG were 1.35 times more likely to have an adverse outcome (OR 1.35, 95% CI 1.03-1.76).
STIs in HIV-infected pregnant women are associated with adverse outcomes in HIV-exposed infected and uninfected infants.
Url:
DOI: 10.1097/INF.0000000000001199
PubMed: 27164464
PubMed Central: 4945428
Affiliations:
- Afrique du Sud, Argentine, Brésil, États-Unis
- Californie, État de São Paulo
- São Paulo
- Université de São Paulo
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PMC:4945428Le document en format XML
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and <italic>Neisseria
gonorrhoeae</italic>
in HIV-infected Pregnant Women and Adverse Infant
Outcomes</title>
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<author><name sortKey="Morgado, Mariza G" sort="Morgado, Mariza G" uniqKey="Morgado M" first="Mariza G." last="Morgado">Mariza G. Morgado</name>
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<author><name sortKey="Gray, Glenda" sort="Gray, Glenda" uniqKey="Gray G" first="Glenda" last="Gray">Glenda Gray</name>
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<author><name sortKey="Santos, Breno" sort="Santos, Breno" uniqKey="Santos B" first="Breno" last="Santos">Breno Santos</name>
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<author><name sortKey="Mussi Pinhata, Marisa M" sort="Mussi Pinhata, Marisa M" uniqKey="Mussi Pinhata M" first="Marisa M." last="Mussi-Pinhata">Marisa M. Mussi-Pinhata</name>
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<author><name sortKey="Ceriotto, Mariana" sort="Ceriotto, Mariana" uniqKey="Ceriotto M" first="Mariana" last="Ceriotto">Mariana Ceriotto</name>
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<author><name sortKey="Machado, Daisy Maria" sort="Machado, Daisy Maria" uniqKey="Machado D" first="Daisy Maria" last="Machado">Daisy Maria Machado</name>
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<author><name sortKey="Bryson, Yvonne J" sort="Bryson, Yvonne J" uniqKey="Bryson Y" first="Yvonne J." last="Bryson">Yvonne J. Bryson</name>
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<country xml:lang="fr" wicri:curation="lc">États-Unis</country>
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<author><name sortKey="Grinsztejn, Beatriz" sort="Grinsztejn, Beatriz" uniqKey="Grinsztejn B" first="Beatriz" last="Grinsztejn">Beatriz Grinsztejn</name>
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<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, 21045-900</wicri:regionArea>
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<author><name sortKey="Bastos, Francisco I" sort="Bastos, Francisco I" uniqKey="Bastos F" first="Francisco I." last="Bastos">Francisco I. Bastos</name>
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<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, 21045-900</wicri:regionArea>
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<author><name sortKey="Siberry, George" sort="Siberry, George" uniqKey="Siberry G" first="George" last="Siberry">George Siberry</name>
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<country xml:lang="fr" wicri:curation="lc">États-Unis</country>
<wicri:regionArea>Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, 20892-7510</wicri:regionArea>
<wicri:noRegion>20892-7510</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Nielsen Saines, Karin" sort="Nielsen Saines, Karin" uniqKey="Nielsen Saines K" first="Karin" last="Nielsen-Saines">Karin Nielsen-Saines</name>
<affiliation wicri:level="2"><nlm:aff id="A1">David Geffen UCLA School of Medicine, Los Angeles, CA 90095-1406, U.S.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">États-Unis</country>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main"><italic>Chlamydia trachomatis</italic>
and <italic>Neisseria
gonorrhoeae</italic>
in HIV-infected Pregnant Women and Adverse Infant
Outcomes</title>
<author><name sortKey="Adachi, Kristina" sort="Adachi, Kristina" uniqKey="Adachi K" first="Kristina" last="Adachi">Kristina Adachi</name>
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<country xml:lang="fr" wicri:curation="lc">États-Unis</country>
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<author><name sortKey="Xu, Jiahong" sort="Xu, Jiahong" uniqKey="Xu J" first="Jiahong" last="Xu">Jiahong Xu</name>
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<country xml:lang="fr" wicri:curation="lc">États-Unis</country>
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<author><name sortKey="Ank, Bonnie" sort="Ank, Bonnie" uniqKey="Ank B" first="Bonnie" last="Ank">Bonnie Ank</name>
<affiliation wicri:level="2"><nlm:aff id="A1">David Geffen UCLA School of Medicine, Los Angeles, CA 90095-1406, U.S.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">États-Unis</country>
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</placeName>
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<author><name sortKey="Bristow, Claire C" sort="Bristow, Claire C" uniqKey="Bristow C" first="Claire C." last="Bristow">Claire C. Bristow</name>
<affiliation wicri:level="1"><nlm:aff id="A3">UCSD School of Medicine, Division of Global Public Health, La Jolla, CA, 92093, U.S.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">États-Unis</country>
<wicri:regionArea>UCSD School of Medicine, Division of Global Public Health, La Jolla, CA, 92093</wicri:regionArea>
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<author><name sortKey="Morgado, Mariza G" sort="Morgado, Mariza G" uniqKey="Morgado M" first="Mariza G." last="Morgado">Mariza G. Morgado</name>
<affiliation wicri:level="1"><nlm:aff id="A4">Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, 21045-900, Brazil</nlm:aff>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, 21045-900</wicri:regionArea>
<wicri:noRegion>21045-900</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Watts, D Heather" sort="Watts, D Heather" uniqKey="Watts D" first="D. Heather" last="Watts">D. Heather Watts</name>
<affiliation wicri:level="1"><nlm:aff id="A5">Office of the Global AIDS Coordinator, U.S. Department of State, Washington D.C., 20522-2920, U.S.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">États-Unis</country>
<wicri:regionArea>Office of the Global AIDS Coordinator, U.S. Department of State, Washington D.C., 20522-2920</wicri:regionArea>
<wicri:noRegion>20522-2920</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Weir, Fred" sort="Weir, Fred" uniqKey="Weir F" first="Fred" last="Weir">Fred Weir</name>
<affiliation wicri:level="2"><nlm:aff id="A6">Cepheid, Sunnyvale, CA 94089, U.S.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">États-Unis</country>
<wicri:regionArea>Cepheid, Sunnyvale, CA 94089</wicri:regionArea>
<placeName><region type="state">Californie</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Persing, David" sort="Persing, David" uniqKey="Persing D" first="David" last="Persing">David Persing</name>
<affiliation wicri:level="2"><nlm:aff id="A6">Cepheid, Sunnyvale, CA 94089, U.S.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">États-Unis</country>
<wicri:regionArea>Cepheid, Sunnyvale, CA 94089</wicri:regionArea>
<placeName><region type="state">Californie</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mofenson, Lynne M" sort="Mofenson, Lynne M" uniqKey="Mofenson L" first="Lynne M." last="Mofenson">Lynne M. Mofenson</name>
<affiliation wicri:level="1"><nlm:aff id="A7">Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, 20892-7510, U.S.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">États-Unis</country>
<wicri:regionArea>Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, 20892-7510</wicri:regionArea>
<wicri:noRegion>20892-7510</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Veloso, Valdilea G" sort="Veloso, Valdilea G" uniqKey="Veloso V" first="Valdilea G." last="Veloso">Valdilea G. Veloso</name>
<affiliation wicri:level="1"><nlm:aff id="A4">Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, 21045-900, Brazil</nlm:aff>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, 21045-900</wicri:regionArea>
<wicri:noRegion>21045-900</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Pilotto, Jose Henrique" sort="Pilotto, Jose Henrique" uniqKey="Pilotto J" first="Jose Henrique" last="Pilotto">Jose Henrique Pilotto</name>
<affiliation wicri:level="1"><nlm:aff id="A8">Hospital Geral de Nova Iguaçu, Nova Iguaçu, RJ, 26030-380, Brazil</nlm:aff>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Hospital Geral de Nova Iguaçu, Nova Iguaçu, RJ, 26030-380</wicri:regionArea>
<wicri:noRegion>26030-380</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Joao, Esau" sort="Joao, Esau" uniqKey="Joao E" first="Esau" last="Joao">Esau Joao</name>
<affiliation wicri:level="1"><nlm:aff id="A9">Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, 20221-903, Brazil</nlm:aff>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, 20221-903</wicri:regionArea>
<wicri:noRegion>20221-903</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Gray, Glenda" sort="Gray, Glenda" uniqKey="Gray G" first="Glenda" last="Gray">Glenda Gray</name>
<affiliation wicri:level="1"><nlm:aff id="A10">SAMRC and Perinatal HIV Research Unit, University of Witwatersrand, Cape Town, 7441, South Africa</nlm:aff>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>SAMRC and Perinatal HIV Research Unit, University of Witwatersrand, Cape Town, 7441</wicri:regionArea>
<wicri:noRegion>7441</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Theron, Gerhard" sort="Theron, Gerhard" uniqKey="Theron G" first="Gerhard" last="Theron">Gerhard Theron</name>
<affiliation wicri:level="1"><nlm:aff id="A11">Stellenbosch University/Tygerberg Hospital, Cape Town, 7505, South Africa</nlm:aff>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>Stellenbosch University/Tygerberg Hospital, Cape Town, 7505</wicri:regionArea>
<wicri:noRegion>7505</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Santos, Breno" sort="Santos, Breno" uniqKey="Santos B" first="Breno" last="Santos">Breno Santos</name>
<affiliation wicri:level="1"><nlm:aff id="A12">Hospital Conceicao, Porto Alegre, RS, 91350-200, Brazil</nlm:aff>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Hospital Conceicao, Porto Alegre, RS, 91350-200</wicri:regionArea>
<wicri:noRegion>91350-200</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Fonseca, Rosana" sort="Fonseca, Rosana" uniqKey="Fonseca R" first="Rosana" last="Fonseca">Rosana Fonseca</name>
<affiliation wicri:level="1"><nlm:aff id="A13">Hospital Femina, Porto Alegre, RS, 90430-001, Brazil</nlm:aff>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Hospital Femina, Porto Alegre, RS, 90430-001</wicri:regionArea>
<wicri:noRegion>90430-001</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Kreitchmann, Regis" sort="Kreitchmann, Regis" uniqKey="Kreitchmann R" first="Regis" last="Kreitchmann">Regis Kreitchmann</name>
<affiliation wicri:level="1"><nlm:aff id="A14">Irmandade da Santa Casa de Misericordia de Porto Alegre, RS, 90020-090, Brazil</nlm:aff>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Irmandade da Santa Casa de Misericordia de Porto Alegre, RS, 90020-090</wicri:regionArea>
<wicri:noRegion>90020-090</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Pinto, Jorge" sort="Pinto, Jorge" uniqKey="Pinto J" first="Jorge" last="Pinto">Jorge Pinto</name>
<affiliation wicri:level="1"><nlm:aff id="A15">Federal University of Minas Gerais, Belo Horizonte, MG, 30130-100, Brazil</nlm:aff>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Federal University of Minas Gerais, Belo Horizonte, MG, 30130-100</wicri:regionArea>
<wicri:noRegion>30130-100</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Mussi Pinhata, Marisa M" sort="Mussi Pinhata, Marisa M" uniqKey="Mussi Pinhata M" first="Marisa M." last="Mussi-Pinhata">Marisa M. Mussi-Pinhata</name>
<affiliation wicri:level="4"><nlm:aff id="A16">Ribeirão Preto Medical School, University of São Paulo, SP, 14049-900, Brazil</nlm:aff>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Ribeirão Preto Medical School, University of São Paulo, SP, 14049-900</wicri:regionArea>
<orgName type="university">Université de São Paulo</orgName>
<placeName><settlement type="city">São Paulo</settlement>
<region type="state">État de São Paulo</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Ceriotto, Mariana" sort="Ceriotto, Mariana" uniqKey="Ceriotto M" first="Mariana" last="Ceriotto">Mariana Ceriotto</name>
<affiliation wicri:level="1"><nlm:aff id="A17">Foundation for Maternal and Infant Health (FUNDASAMIN), Buenos Aires, C1439CNU, Argentina</nlm:aff>
<country xml:lang="fr">Argentine</country>
<wicri:regionArea>Foundation for Maternal and Infant Health (FUNDASAMIN), Buenos Aires, C1439CNU</wicri:regionArea>
<wicri:noRegion>C1439CNU</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Machado, Daisy Maria" sort="Machado, Daisy Maria" uniqKey="Machado D" first="Daisy Maria" last="Machado">Daisy Maria Machado</name>
<affiliation wicri:level="1"><nlm:aff id="A18">Escola Paulista de Medicina-Universidade Federal de São Paulo, São Paulo, SP, 04939-002, Brazil</nlm:aff>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Escola Paulista de Medicina-Universidade Federal de São Paulo, São Paulo, SP, 04939-002</wicri:regionArea>
<wicri:noRegion>04939-002</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Bryson, Yvonne J" sort="Bryson, Yvonne J" uniqKey="Bryson Y" first="Yvonne J." last="Bryson">Yvonne J. Bryson</name>
<affiliation wicri:level="2"><nlm:aff id="A1">David Geffen UCLA School of Medicine, Los Angeles, CA 90095-1406, U.S.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">États-Unis</country>
<wicri:regionArea>David Geffen UCLA School of Medicine, Los Angeles, CA 90095-1406</wicri:regionArea>
<placeName><region type="state">Californie</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Grinsztejn, Beatriz" sort="Grinsztejn, Beatriz" uniqKey="Grinsztejn B" first="Beatriz" last="Grinsztejn">Beatriz Grinsztejn</name>
<affiliation wicri:level="1"><nlm:aff id="A4">Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, 21045-900, Brazil</nlm:aff>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, 21045-900</wicri:regionArea>
<wicri:noRegion>21045-900</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Bastos, Francisco I" sort="Bastos, Francisco I" uniqKey="Bastos F" first="Francisco I." last="Bastos">Francisco I. Bastos</name>
<affiliation wicri:level="1"><nlm:aff id="A4">Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, 21045-900, Brazil</nlm:aff>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, 21045-900</wicri:regionArea>
<wicri:noRegion>21045-900</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Siberry, George" sort="Siberry, George" uniqKey="Siberry G" first="George" last="Siberry">George Siberry</name>
<affiliation wicri:level="1"><nlm:aff id="A7">Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, 20892-7510, U.S.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">États-Unis</country>
<wicri:regionArea>Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, 20892-7510</wicri:regionArea>
<wicri:noRegion>20892-7510</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Nielsen Saines, Karin" sort="Nielsen Saines, Karin" uniqKey="Nielsen Saines K" first="Karin" last="Nielsen-Saines">Karin Nielsen-Saines</name>
<affiliation wicri:level="2"><nlm:aff id="A1">David Geffen UCLA School of Medicine, Los Angeles, CA 90095-1406, U.S.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">États-Unis</country>
<wicri:regionArea>David Geffen UCLA School of Medicine, Los Angeles, CA 90095-1406</wicri:regionArea>
<placeName><region type="state">Californie</region>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j">The Pediatric infectious disease journal</title>
<idno type="ISSN">0891-3668</idno>
<idno type="eISSN">1532-0987</idno>
<imprint><date when="2016">2016</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>BACKGROUND</title>
<p id="P2">Sexually transmitted infections (STIs) in pregnancy such as <italic>Chlamydia
trachomatis</italic>
(CT) and <italic>Neisseria gonorrhoeae</italic>
(NG) may lead to
adverse infant outcomes.</p>
</sec>
<sec id="S2"><title>METHODOLOGY</title>
<p id="P3">Individual urine specimens from HIV-infected pregnant women diagnosed with HIV
during labor were collected at the time of infant birth and tested by polymerase chain
reaction for CT and NG. Infant HIV infection was determined at 3 months with
morbidity/mortality assessed through 6 months.</p>
</sec>
<sec id="S3"><title>RESULTS</title>
<p id="P4">Of 1373 maternal urines, 277 (20.2%) were positive for CT and/or NG; 249
(18.1%) for CT, 63 (4.6%) for NG, and 35 (2.5%) for both CT and NG. HIV infection was
diagnosed in 117 (8.5%) infants. Highest rates of adverse outcomes (sepsis, pneumonia,
congenital syphilis, septic arthritis, conjunctivitis, low birth weight, preterm
delivery, death) were noted in infants of women with CT and NG (23/35, 65.7%) compared
to NG (16/28, 57.1%), CT (84/214, 39.3%), and no STI (405/1096, 37%, p=0.001). Death
(11.4% vs. 3%, p=0.02), low birth weight (42.9% vs. 16.9%, p=0.001), and preterm
delivery (28.6% vs. 10.2%, p=0.008) were higher among infants of CT and NG
co-infected women. Infants who had any adverse outcome and were born to women with CT
and/or NG were 3.5 times more likely to be HIV-infected after controlling for maternal
syphilis (OR 3.5, 95% CI 1.4-8.3). By adjusted multivariate logistic regression, infants
born to mothers with any CT and/or NG were 1.35 times more likely to have an adverse
outcome (OR 1.35, 95% CI 1.03-1.76).</p>
</sec>
<sec id="S4"><title>CONCLUSION</title>
<p id="P5">STIs in HIV-infected pregnant women are associated with adverse outcomes in
HIV-exposed infected and uninfected infants.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8701858</journal-id>
<journal-id journal-id-type="pubmed-jr-id">6404</journal-id>
<journal-id journal-id-type="nlm-ta">Pediatr Infect Dis J</journal-id>
<journal-id journal-id-type="iso-abbrev">Pediatr. Infect. Dis. J.</journal-id>
<journal-title-group><journal-title>The Pediatric infectious disease journal</journal-title>
</journal-title-group>
<issn pub-type="ppub">0891-3668</issn>
<issn pub-type="epub">1532-0987</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">27164464</article-id>
<article-id pub-id-type="pmc">4945428</article-id>
<article-id pub-id-type="doi">10.1097/INF.0000000000001199</article-id>
<article-id pub-id-type="manuscript">NIHMS783968</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title><italic>Chlamydia trachomatis</italic>
and <italic>Neisseria
gonorrhoeae</italic>
in HIV-infected Pregnant Women and Adverse Infant
Outcomes</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Adachi</surname>
<given-names>Kristina</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Klausner</surname>
<given-names>Jeffrey D.</given-names>
</name>
<degrees>MD, MPH</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Xu</surname>
<given-names>Jiahong</given-names>
</name>
<degrees>MS, MPH</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ank</surname>
<given-names>Bonnie</given-names>
</name>
<degrees>BA</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bristow</surname>
<given-names>Claire C.</given-names>
</name>
<degrees>PhD, MPH, MSc</degrees>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Morgado</surname>
<given-names>Mariza G.</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Watts</surname>
<given-names>D. Heather</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Weir</surname>
<given-names>Fred</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A6">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Persing</surname>
<given-names>David</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="A6">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mofenson</surname>
<given-names>Lynne M.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A7">7</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Veloso</surname>
<given-names>Valdilea G.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Pilotto</surname>
<given-names>Jose Henrique</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A8">8</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Joao</surname>
<given-names>Esau</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A9">9</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gray</surname>
<given-names>Glenda</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A10">10</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Theron</surname>
<given-names>Gerhard</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A11">11</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Santos</surname>
<given-names>Breno</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A12">12</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Fonseca</surname>
<given-names>Rosana</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A13">13</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kreitchmann</surname>
<given-names>Regis</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A14">14</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Pinto</surname>
<given-names>Jorge</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A15">15</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mussi-Pinhata</surname>
<given-names>Marisa M.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A16">16</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ceriotto</surname>
<given-names>Mariana</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A17">17</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Machado</surname>
<given-names>Daisy Maria</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A18">18</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bryson</surname>
<given-names>Yvonne J.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Grinsztejn</surname>
<given-names>Beatriz</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bastos</surname>
<given-names>Francisco I.</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Siberry</surname>
<given-names>George</given-names>
</name>
<degrees>MD, MPH</degrees>
<xref ref-type="aff" rid="A7">7</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nielsen-Saines</surname>
<given-names>Karin</given-names>
</name>
<degrees>MD, MPH</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<on-behalf-of>for the NICHD HPTN 040 Study Team</on-behalf-of>
</contrib-group>
<aff id="A1"><label>1</label>
David Geffen UCLA School of Medicine, Los Angeles, CA 90095-1406, U.S.</aff>
<aff id="A2"><label>2</label>
Westat, Rockville, MD, 20850-2062, U.S.</aff>
<aff id="A3"><label>3</label>
UCSD School of Medicine, Division of Global Public Health, La Jolla, CA, 92093, U.S.</aff>
<aff id="A4"><label>4</label>
Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, 21045-900, Brazil</aff>
<aff id="A5"><label>5</label>
Office of the Global AIDS Coordinator, U.S. Department of State, Washington D.C., 20522-2920, U.S.</aff>
<aff id="A6"><label>6</label>
Cepheid, Sunnyvale, CA 94089, U.S.</aff>
<aff id="A7"><label>7</label>
Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, 20892-7510, U.S.</aff>
<aff id="A8"><label>8</label>
Hospital Geral de Nova Iguaçu, Nova Iguaçu, RJ, 26030-380, Brazil</aff>
<aff id="A9"><label>9</label>
Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, 20221-903, Brazil</aff>
<aff id="A10"><label>10</label>
SAMRC and Perinatal HIV Research Unit, University of Witwatersrand, Cape Town, 7441, South Africa</aff>
<aff id="A11"><label>11</label>
Stellenbosch University/Tygerberg Hospital, Cape Town, 7505, South Africa</aff>
<aff id="A12"><label>12</label>
Hospital Conceicao, Porto Alegre, RS, 91350-200, Brazil</aff>
<aff id="A13"><label>13</label>
Hospital Femina, Porto Alegre, RS, 90430-001, Brazil</aff>
<aff id="A14"><label>14</label>
Irmandade da Santa Casa de Misericordia de Porto Alegre, RS, 90020-090, Brazil</aff>
<aff id="A15"><label>15</label>
Federal University of Minas Gerais, Belo Horizonte, MG, 30130-100, Brazil</aff>
<aff id="A16"><label>16</label>
Ribeirão Preto Medical School, University of São Paulo, SP, 14049-900, Brazil</aff>
<aff id="A17"><label>17</label>
Foundation for Maternal and Infant Health (FUNDASAMIN), Buenos Aires, C1439CNU, Argentina</aff>
<aff id="A18"><label>18</label>
Escola Paulista de Medicina-Universidade Federal de São Paulo, São Paulo, SP, 04939-002, Brazil</aff>
<author-notes><corresp id="CR1"><bold>Corresponding Author</bold>
: Kristina Adachi, MD, David Geffen
School of Medicine at UCLA, Department of Pediatrics, Division of Infectious Diseases,
10833 Le Conte Ave, MDCC 22-442, Los Angeles, CA 90095-1406, Phone: 310-825-5235 Fax:
310-206-4764 <email>kadachi@mednet.ucla.edu</email>
</corresp>
<fn fn-type="current-aff" id="FN1"><p id="P1">Change of Author Affiliations: Lynne Mofenson, MD has retired from service at
the Eunice Kennedy Shriver National Institute of Child Health and Human Development,
National Institutes of Health, Bethesda, MD, U.S. D. Heather Watts, MD and George Siberry,
MD, MPH were previously at the Eunice Kennedy Shriver National Institute of Child Health
and Human Development, National Institutes of Health, Bethesda, MD, U.S., but are now
currently at the Office of the Global AIDS Coordinator, U.S. Department of State,
Washington D.C., U.S.</p>
</fn>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>15</day>
<month>5</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="ppub"><month>8</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>8</month>
<year>2017</year>
</pub-date>
<volume>35</volume>
<issue>8</issue>
<fpage>894</fpage>
<lpage>900</lpage>
<pmc-comment>elocation-id from pubmed: 10.1097/INF.0000000000001199</pmc-comment>
<abstract><sec id="S1"><title>BACKGROUND</title>
<p id="P2">Sexually transmitted infections (STIs) in pregnancy such as <italic>Chlamydia
trachomatis</italic>
(CT) and <italic>Neisseria gonorrhoeae</italic>
(NG) may lead to
adverse infant outcomes.</p>
</sec>
<sec id="S2"><title>METHODOLOGY</title>
<p id="P3">Individual urine specimens from HIV-infected pregnant women diagnosed with HIV
during labor were collected at the time of infant birth and tested by polymerase chain
reaction for CT and NG. Infant HIV infection was determined at 3 months with
morbidity/mortality assessed through 6 months.</p>
</sec>
<sec id="S3"><title>RESULTS</title>
<p id="P4">Of 1373 maternal urines, 277 (20.2%) were positive for CT and/or NG; 249
(18.1%) for CT, 63 (4.6%) for NG, and 35 (2.5%) for both CT and NG. HIV infection was
diagnosed in 117 (8.5%) infants. Highest rates of adverse outcomes (sepsis, pneumonia,
congenital syphilis, septic arthritis, conjunctivitis, low birth weight, preterm
delivery, death) were noted in infants of women with CT and NG (23/35, 65.7%) compared
to NG (16/28, 57.1%), CT (84/214, 39.3%), and no STI (405/1096, 37%, p=0.001). Death
(11.4% vs. 3%, p=0.02), low birth weight (42.9% vs. 16.9%, p=0.001), and preterm
delivery (28.6% vs. 10.2%, p=0.008) were higher among infants of CT and NG
co-infected women. Infants who had any adverse outcome and were born to women with CT
and/or NG were 3.5 times more likely to be HIV-infected after controlling for maternal
syphilis (OR 3.5, 95% CI 1.4-8.3). By adjusted multivariate logistic regression, infants
born to mothers with any CT and/or NG were 1.35 times more likely to have an adverse
outcome (OR 1.35, 95% CI 1.03-1.76).</p>
</sec>
<sec id="S4"><title>CONCLUSION</title>
<p id="P5">STIs in HIV-infected pregnant women are associated with adverse outcomes in
HIV-exposed infected and uninfected infants.</p>
</sec>
</abstract>
<kwd-group><kwd>HIV</kwd>
<kwd>pregnancy</kwd>
<kwd>chlamydia</kwd>
<kwd>gonorrhea</kwd>
<kwd>sexually transmitted infections</kwd>
<kwd>adverse infant outcomes</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Afrique du Sud</li>
<li>Argentine</li>
<li>Brésil</li>
<li>États-Unis</li>
</country>
<region><li>Californie</li>
<li>État de São Paulo</li>
</region>
<settlement><li>São Paulo</li>
</settlement>
<orgName><li>Université de São Paulo</li>
</orgName>
</list>
<tree><country name="États-Unis"><region name="Californie"><name sortKey="Adachi, Kristina" sort="Adachi, Kristina" uniqKey="Adachi K" first="Kristina" last="Adachi">Kristina Adachi</name>
</region>
<name sortKey="Ank, Bonnie" sort="Ank, Bonnie" uniqKey="Ank B" first="Bonnie" last="Ank">Bonnie Ank</name>
<name sortKey="Bristow, Claire C" sort="Bristow, Claire C" uniqKey="Bristow C" first="Claire C." last="Bristow">Claire C. Bristow</name>
<name sortKey="Bryson, Yvonne J" sort="Bryson, Yvonne J" uniqKey="Bryson Y" first="Yvonne J." last="Bryson">Yvonne J. Bryson</name>
<name sortKey="Klausner, Jeffrey D" sort="Klausner, Jeffrey D" uniqKey="Klausner J" first="Jeffrey D." last="Klausner">Jeffrey D. Klausner</name>
<name sortKey="Mofenson, Lynne M" sort="Mofenson, Lynne M" uniqKey="Mofenson L" first="Lynne M." last="Mofenson">Lynne M. Mofenson</name>
<name sortKey="Nielsen Saines, Karin" sort="Nielsen Saines, Karin" uniqKey="Nielsen Saines K" first="Karin" last="Nielsen-Saines">Karin Nielsen-Saines</name>
<name sortKey="Persing, David" sort="Persing, David" uniqKey="Persing D" first="David" last="Persing">David Persing</name>
<name sortKey="Siberry, George" sort="Siberry, George" uniqKey="Siberry G" first="George" last="Siberry">George Siberry</name>
<name sortKey="Watts, D Heather" sort="Watts, D Heather" uniqKey="Watts D" first="D. Heather" last="Watts">D. Heather Watts</name>
<name sortKey="Weir, Fred" sort="Weir, Fred" uniqKey="Weir F" first="Fred" last="Weir">Fred Weir</name>
<name sortKey="Xu, Jiahong" sort="Xu, Jiahong" uniqKey="Xu J" first="Jiahong" last="Xu">Jiahong Xu</name>
</country>
<country name="Brésil"><noRegion><name sortKey="Morgado, Mariza G" sort="Morgado, Mariza G" uniqKey="Morgado M" first="Mariza G." last="Morgado">Mariza G. Morgado</name>
</noRegion>
<name sortKey="Bastos, Francisco I" sort="Bastos, Francisco I" uniqKey="Bastos F" first="Francisco I." last="Bastos">Francisco I. Bastos</name>
<name sortKey="Fonseca, Rosana" sort="Fonseca, Rosana" uniqKey="Fonseca R" first="Rosana" last="Fonseca">Rosana Fonseca</name>
<name sortKey="Grinsztejn, Beatriz" sort="Grinsztejn, Beatriz" uniqKey="Grinsztejn B" first="Beatriz" last="Grinsztejn">Beatriz Grinsztejn</name>
<name sortKey="Joao, Esau" sort="Joao, Esau" uniqKey="Joao E" first="Esau" last="Joao">Esau Joao</name>
<name sortKey="Kreitchmann, Regis" sort="Kreitchmann, Regis" uniqKey="Kreitchmann R" first="Regis" last="Kreitchmann">Regis Kreitchmann</name>
<name sortKey="Machado, Daisy Maria" sort="Machado, Daisy Maria" uniqKey="Machado D" first="Daisy Maria" last="Machado">Daisy Maria Machado</name>
<name sortKey="Mussi Pinhata, Marisa M" sort="Mussi Pinhata, Marisa M" uniqKey="Mussi Pinhata M" first="Marisa M." last="Mussi-Pinhata">Marisa M. Mussi-Pinhata</name>
<name sortKey="Pilotto, Jose Henrique" sort="Pilotto, Jose Henrique" uniqKey="Pilotto J" first="Jose Henrique" last="Pilotto">Jose Henrique Pilotto</name>
<name sortKey="Pinto, Jorge" sort="Pinto, Jorge" uniqKey="Pinto J" first="Jorge" last="Pinto">Jorge Pinto</name>
<name sortKey="Santos, Breno" sort="Santos, Breno" uniqKey="Santos B" first="Breno" last="Santos">Breno Santos</name>
<name sortKey="Veloso, Valdilea G" sort="Veloso, Valdilea G" uniqKey="Veloso V" first="Valdilea G." last="Veloso">Valdilea G. Veloso</name>
</country>
<country name="Afrique du Sud"><noRegion><name sortKey="Gray, Glenda" sort="Gray, Glenda" uniqKey="Gray G" first="Glenda" last="Gray">Glenda Gray</name>
</noRegion>
<name sortKey="Theron, Gerhard" sort="Theron, Gerhard" uniqKey="Theron G" first="Gerhard" last="Theron">Gerhard Theron</name>
</country>
<country name="Argentine"><noRegion><name sortKey="Ceriotto, Mariana" sort="Ceriotto, Mariana" uniqKey="Ceriotto M" first="Mariana" last="Ceriotto">Mariana Ceriotto</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>
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