Chlamydia trachomatis and Neisseria gonorrhoeae in HIV-infected Pregnant Women and Adverse Infant Outcomes
Identifieur interne : 001D25 ( Pmc/Corpus ); précédent : 001D24; suivant : 001D26Chlamydia trachomatis and Neisseria gonorrhoeae in HIV-infected Pregnant Women and Adverse Infant Outcomes
Auteurs : Kristina Adachi ; Jeffrey D. Klausner ; Jiahong Xu ; Bonnie Ank ; Claire C. Bristow ; Mariza G. Morgado ; D. Heather Watts ; Fred Weir ; David Persing ; Lynne M. Mofenson ; Valdilea G. Veloso ; Jose Henrique Pilotto ; Esau Joao ; Glenda Gray ; Gerhard Theron ; Breno Santos ; Rosana Fonseca ; Regis Kreitchmann ; Jorge Pinto ; Marisa M. Mussi-Pinhata ; Mariana Ceriotto ; Daisy Maria Machado ; Yvonne J. Bryson ; Beatriz Grinsztejn ; Francisco I. Bastos ; George Siberry ; Karin Nielsen-SainesSource :
- 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
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PMC:4945428Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en"><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><affiliation><nlm:aff id="A1">David Geffen UCLA School of Medicine, Los Angeles, CA 90095-1406, U.S.</nlm:aff></affiliation></author><author><name sortKey="Klausner, Jeffrey D" sort="Klausner, Jeffrey D" uniqKey="Klausner J" first="Jeffrey D." last="Klausner">Jeffrey D. Klausner</name><affiliation><nlm:aff id="A1">David Geffen UCLA School of Medicine, Los Angeles, CA 90095-1406, U.S.</nlm:aff></affiliation></author><author><name sortKey="Xu, Jiahong" sort="Xu, Jiahong" uniqKey="Xu J" first="Jiahong" last="Xu">Jiahong Xu</name><affiliation><nlm:aff id="A2">Westat, Rockville, MD, 20850-2062, U.S.</nlm:aff></affiliation></author><author><name sortKey="Ank, Bonnie" sort="Ank, Bonnie" uniqKey="Ank B" first="Bonnie" last="Ank">Bonnie Ank</name><affiliation><nlm:aff id="A1">David Geffen UCLA School of Medicine, Los Angeles, CA 90095-1406, U.S.</nlm:aff></affiliation></author><author><name sortKey="Bristow, Claire C" sort="Bristow, Claire C" uniqKey="Bristow C" first="Claire C." last="Bristow">Claire C. Bristow</name><affiliation><nlm:aff id="A3">UCSD School of Medicine, Division of Global Public Health, La Jolla, CA, 92093, U.S.</nlm:aff></affiliation></author><author><name sortKey="Morgado, Mariza G" sort="Morgado, Mariza G" uniqKey="Morgado M" first="Mariza G." last="Morgado">Mariza G. Morgado</name><affiliation><nlm:aff id="A4">Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, 21045-900, Brazil</nlm:aff></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><nlm:aff id="A5">Office of the Global AIDS Coordinator, U.S. Department of State, Washington D.C., 20522-2920, U.S.</nlm:aff></affiliation></author><author><name sortKey="Weir, Fred" sort="Weir, Fred" uniqKey="Weir F" first="Fred" last="Weir">Fred Weir</name><affiliation><nlm:aff id="A6">Cepheid, Sunnyvale, CA 94089, U.S.</nlm:aff></affiliation></author><author><name sortKey="Persing, David" sort="Persing, David" uniqKey="Persing D" first="David" last="Persing">David Persing</name><affiliation><nlm:aff id="A6">Cepheid, Sunnyvale, CA 94089, U.S.</nlm:aff></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><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></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><nlm:aff id="A4">Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, 21045-900, Brazil</nlm:aff></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><nlm:aff id="A8">Hospital Geral de Nova Iguaçu, Nova Iguaçu, RJ, 26030-380, Brazil</nlm:aff></affiliation></author><author><name sortKey="Joao, Esau" sort="Joao, Esau" uniqKey="Joao E" first="Esau" last="Joao">Esau Joao</name><affiliation><nlm:aff id="A9">Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, 20221-903, Brazil</nlm:aff></affiliation></author><author><name sortKey="Gray, Glenda" sort="Gray, Glenda" uniqKey="Gray G" first="Glenda" last="Gray">Glenda Gray</name><affiliation><nlm:aff id="A10">SAMRC and Perinatal HIV Research Unit, University of Witwatersrand, Cape Town, 7441, South Africa</nlm:aff></affiliation></author><author><name sortKey="Theron, Gerhard" sort="Theron, Gerhard" uniqKey="Theron G" first="Gerhard" last="Theron">Gerhard Theron</name><affiliation><nlm:aff id="A11">Stellenbosch University/Tygerberg Hospital, Cape Town, 7505, South Africa</nlm:aff></affiliation></author><author><name sortKey="Santos, Breno" sort="Santos, Breno" uniqKey="Santos B" first="Breno" last="Santos">Breno Santos</name><affiliation><nlm:aff id="A12">Hospital Conceicao, Porto Alegre, RS, 91350-200, Brazil</nlm:aff></affiliation></author><author><name sortKey="Fonseca, Rosana" sort="Fonseca, Rosana" uniqKey="Fonseca R" first="Rosana" last="Fonseca">Rosana Fonseca</name><affiliation><nlm:aff id="A13">Hospital Femina, Porto Alegre, RS, 90430-001, Brazil</nlm:aff></affiliation></author><author><name sortKey="Kreitchmann, Regis" sort="Kreitchmann, Regis" uniqKey="Kreitchmann R" first="Regis" last="Kreitchmann">Regis Kreitchmann</name><affiliation><nlm:aff id="A14">Irmandade da Santa Casa de Misericordia de Porto Alegre, RS, 90020-090, Brazil</nlm:aff></affiliation></author><author><name sortKey="Pinto, Jorge" sort="Pinto, Jorge" uniqKey="Pinto J" first="Jorge" last="Pinto">Jorge Pinto</name><affiliation><nlm:aff id="A15">Federal University of Minas Gerais, Belo Horizonte, MG, 30130-100, Brazil</nlm:aff></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><nlm:aff id="A16">Ribeirão Preto Medical School, University of São Paulo, SP, 14049-900, Brazil</nlm:aff></affiliation></author><author><name sortKey="Ceriotto, Mariana" sort="Ceriotto, Mariana" uniqKey="Ceriotto M" first="Mariana" last="Ceriotto">Mariana Ceriotto</name><affiliation><nlm:aff id="A17">Foundation for Maternal and Infant Health (FUNDASAMIN), Buenos Aires, C1439CNU, Argentina</nlm:aff></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><nlm:aff id="A18">Escola Paulista de Medicina-Universidade Federal de São Paulo, São Paulo, SP, 04939-002, Brazil</nlm:aff></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><nlm:aff id="A1">David Geffen UCLA School of Medicine, Los Angeles, CA 90095-1406, U.S.</nlm:aff></affiliation></author><author><name sortKey="Grinsztejn, Beatriz" sort="Grinsztejn, Beatriz" uniqKey="Grinsztejn B" first="Beatriz" last="Grinsztejn">Beatriz Grinsztejn</name><affiliation><nlm:aff id="A4">Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, 21045-900, Brazil</nlm:aff></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><nlm:aff id="A4">Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, 21045-900, Brazil</nlm:aff></affiliation></author><author><name sortKey="Siberry, George" sort="Siberry, George" uniqKey="Siberry G" first="George" last="Siberry">George Siberry</name><affiliation><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></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><nlm:aff id="A1">David Geffen UCLA School of Medicine, Los Angeles, CA 90095-1406, U.S.</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27164464</idno><idno type="pmc">4945428</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4945428</idno><idno type="RBID">PMC:4945428</idno><idno type="doi">10.1097/INF.0000000000001199</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">001D25</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001D25</idno></publicationStmt><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><affiliation><nlm:aff id="A1">David Geffen UCLA School of Medicine, Los Angeles, CA 90095-1406, U.S.</nlm:aff></affiliation></author><author><name sortKey="Klausner, Jeffrey D" sort="Klausner, Jeffrey D" uniqKey="Klausner J" first="Jeffrey D." last="Klausner">Jeffrey D. Klausner</name><affiliation><nlm:aff id="A1">David Geffen UCLA School of Medicine, Los Angeles, CA 90095-1406, U.S.</nlm:aff></affiliation></author><author><name sortKey="Xu, Jiahong" sort="Xu, Jiahong" uniqKey="Xu J" first="Jiahong" last="Xu">Jiahong Xu</name><affiliation><nlm:aff id="A2">Westat, Rockville, MD, 20850-2062, U.S.</nlm:aff></affiliation></author><author><name sortKey="Ank, Bonnie" sort="Ank, Bonnie" uniqKey="Ank B" first="Bonnie" last="Ank">Bonnie Ank</name><affiliation><nlm:aff id="A1">David Geffen UCLA School of Medicine, Los Angeles, CA 90095-1406, U.S.</nlm:aff></affiliation></author><author><name sortKey="Bristow, Claire C" sort="Bristow, Claire C" uniqKey="Bristow C" first="Claire C." last="Bristow">Claire C. Bristow</name><affiliation><nlm:aff id="A3">UCSD School of Medicine, Division of Global Public Health, La Jolla, CA, 92093, U.S.</nlm:aff></affiliation></author><author><name sortKey="Morgado, Mariza G" sort="Morgado, Mariza G" uniqKey="Morgado M" first="Mariza G." last="Morgado">Mariza G. Morgado</name><affiliation><nlm:aff id="A4">Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, 21045-900, Brazil</nlm:aff></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><nlm:aff id="A5">Office of the Global AIDS Coordinator, U.S. Department of State, Washington D.C., 20522-2920, U.S.</nlm:aff></affiliation></author><author><name sortKey="Weir, Fred" sort="Weir, Fred" uniqKey="Weir F" first="Fred" last="Weir">Fred Weir</name><affiliation><nlm:aff id="A6">Cepheid, Sunnyvale, CA 94089, U.S.</nlm:aff></affiliation></author><author><name sortKey="Persing, David" sort="Persing, David" uniqKey="Persing D" first="David" last="Persing">David Persing</name><affiliation><nlm:aff id="A6">Cepheid, Sunnyvale, CA 94089, U.S.</nlm:aff></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><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></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><nlm:aff id="A4">Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, 21045-900, Brazil</nlm:aff></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><nlm:aff id="A8">Hospital Geral de Nova Iguaçu, Nova Iguaçu, RJ, 26030-380, Brazil</nlm:aff></affiliation></author><author><name sortKey="Joao, Esau" sort="Joao, Esau" uniqKey="Joao E" first="Esau" last="Joao">Esau Joao</name><affiliation><nlm:aff id="A9">Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, 20221-903, Brazil</nlm:aff></affiliation></author><author><name sortKey="Gray, Glenda" sort="Gray, Glenda" uniqKey="Gray G" first="Glenda" last="Gray">Glenda Gray</name><affiliation><nlm:aff id="A10">SAMRC and Perinatal HIV Research Unit, University of Witwatersrand, Cape Town, 7441, South Africa</nlm:aff></affiliation></author><author><name sortKey="Theron, Gerhard" sort="Theron, Gerhard" uniqKey="Theron G" first="Gerhard" last="Theron">Gerhard Theron</name><affiliation><nlm:aff id="A11">Stellenbosch University/Tygerberg Hospital, Cape Town, 7505, South Africa</nlm:aff></affiliation></author><author><name sortKey="Santos, Breno" sort="Santos, Breno" uniqKey="Santos B" first="Breno" last="Santos">Breno Santos</name><affiliation><nlm:aff id="A12">Hospital Conceicao, Porto Alegre, RS, 91350-200, Brazil</nlm:aff></affiliation></author><author><name sortKey="Fonseca, Rosana" sort="Fonseca, Rosana" uniqKey="Fonseca R" first="Rosana" last="Fonseca">Rosana Fonseca</name><affiliation><nlm:aff id="A13">Hospital Femina, Porto Alegre, RS, 90430-001, Brazil</nlm:aff></affiliation></author><author><name sortKey="Kreitchmann, Regis" sort="Kreitchmann, Regis" uniqKey="Kreitchmann R" first="Regis" last="Kreitchmann">Regis Kreitchmann</name><affiliation><nlm:aff id="A14">Irmandade da Santa Casa de Misericordia de Porto Alegre, RS, 90020-090, Brazil</nlm:aff></affiliation></author><author><name sortKey="Pinto, Jorge" sort="Pinto, Jorge" uniqKey="Pinto J" first="Jorge" last="Pinto">Jorge Pinto</name><affiliation><nlm:aff id="A15">Federal University of Minas Gerais, Belo Horizonte, MG, 30130-100, Brazil</nlm:aff></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><nlm:aff id="A16">Ribeirão Preto Medical School, University of São Paulo, SP, 14049-900, Brazil</nlm:aff></affiliation></author><author><name sortKey="Ceriotto, Mariana" sort="Ceriotto, Mariana" uniqKey="Ceriotto M" first="Mariana" last="Ceriotto">Mariana Ceriotto</name><affiliation><nlm:aff id="A17">Foundation for Maternal and Infant Health (FUNDASAMIN), Buenos Aires, C1439CNU, Argentina</nlm:aff></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><nlm:aff id="A18">Escola Paulista de Medicina-Universidade Federal de São Paulo, São Paulo, SP, 04939-002, Brazil</nlm:aff></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><nlm:aff id="A1">David Geffen UCLA School of Medicine, Los Angeles, CA 90095-1406, U.S.</nlm:aff></affiliation></author><author><name sortKey="Grinsztejn, Beatriz" sort="Grinsztejn, Beatriz" uniqKey="Grinsztejn B" first="Beatriz" last="Grinsztejn">Beatriz Grinsztejn</name><affiliation><nlm:aff id="A4">Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, 21045-900, Brazil</nlm:aff></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><nlm:aff id="A4">Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, 21045-900, Brazil</nlm:aff></affiliation></author><author><name sortKey="Siberry, George" sort="Siberry, George" uniqKey="Siberry G" first="George" last="Siberry">George Siberry</name><affiliation><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></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><nlm:aff id="A1">David Geffen UCLA School of Medicine, Los Angeles, CA 90095-1406, U.S.</nlm:aff></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></record>Pour manipuler ce document sous Unix (Dilib)
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