       Document 0260
 DOCN  M9630260
 TI    Estimated timing of mother-to-child human immunodeficiency virus type 1
       (HIV-1) transmission by use of a Markov model. The HIV Infection in
       Newborns French Collaborative Study Group.
 DT    9603
 AU    Rouzioux C; Costagliola D; Burgard M; Blanche S; Mayaux MJ; Griscelli C;
       Valleron AJ; Laboratoire de Virologie, Hopital Necker-Enfants Malades,
       Paris,; France.
 SO    Am J Epidemiol. 1995 Dec 15;142(12):1330-7. Unique Identifier : AIDSLINE
       MED/96108954
 AB    It has been shown that mother-to-child human immunodeficiency virus type
       1 (HIV-1) transmission can occur both during pregnancy and at delivery,
       but the respective frequencies in these periods are unknown. Moreover,
       it is difficult to determine the timing of mother-to-child HIV-1
       transmission by direct sampling. The use of an elaborate statistical
       method is therefore necessary. The authors studied 495 consecutive
       infants born between May 1988 and August 1991 who were included, at
       birth, in the French Prospective Study on Pediatric HIV Infection. At
       least one blood sample was obtained from every infant during the first
       14 days of life. All samples obtained within 3 months of birth were
       tested by at least two of the following methods: viral culture,
       polymerase chain reaction (PCR), and antigenemia, as well as by Western
       blot test. Data for the 95 infected infants (those seropositive at 18
       months and those who died of HIV disease before this age), and who were
       exclusively bottle-fed, were analyzed in a Markov model to estimate the
       timing of viral transmission, the time from birth to the emergence of
       detectable virus, and the time from birth to seroconversion. The model
       indicated that one-third of the infants were infected in utero, less
       than 2 months before delivery (95th percentile). In the remaining 65% of
       cases (95% confidence interval (CI) 22-92), the date of infection was
       estimated as the day of birth. The estimated median period between birth
       and the emergence of viral markers was 10 days (95% CI 6-14) and the
       95th percentile was estimated at 56 days. These results support the view
       that HIV infection can be diagnosed during the first 3 months of life.
       The authors conclude that mother-to-child HIV-1 transmission appears to
       occur late in pregnancy or at delivery.
 DE    Adult  Biological Markers/BLOOD  *Disease Transmission,
       Vertical/STATISTICS & NUMER DATA  Female  France  Human  HIV
       Antibodies/BLOOD  HIV Infections/BLOOD/*TRANSMISSION  *HIV-1/IMMUNOLOGY
       Infant, Newborn  Markov Chains  Polymerase Chain Reaction/STATISTICS &
       NUMER DATA  Pregnancy  Prospective Studies  Support, Non-U.S. Gov't
       Time Factors  JOURNAL ARTICLE  MULTICENTER STUDY

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

