TY - JOUR AU - Ayisi, John G. AU - van Eijk, Anna M. AU - Newman, Robert D. AU - ter Kuile, Feiko O. AU - Shi, Ya Ping AU - Yang, Chunfu AU - Kolczak, Margarette S. AU - Otieno, Juliana A. AU - Misore, Ambrose O. AU - Kager, Piet A. AU - Lal, Renu B. AU - Steketee, Richard W. AU - Nahlen, Bernard L. T1 - Maternal Malaria and Perinatal HIV Transmission, Western Kenya T2 - Emerging Infectious Disease journal PY - 2004 VL - 10 IS - 4 SP - 643 SN - 1080-6059 AB - To determine whether maternal placental malaria is associated with an increased risk for perinatal mother-to-child HIV transmission (MTCT), we studied HIV-positive women in western Kenya. We enrolled 512 mother-infant pairs; 128 (25.0%) women had malaria, and 102 (19.9%) infants acquired HIV perinatally. Log10 HIV viral load and episiotomy or perineal tear were associated with increased perinatal HIV transmission, whereas low-density malaria (<10,000 parasites/μL) was associated with reduced risk (adjusted relative risk [ARR] 0.4). Among women dually infected with malaria and HIV, high-density malaria (>10,000 parasites/μL) was associated with increased risk for perinatal MTCT (ARR 2.0), compared to low-density malaria. The interaction between placental malaria and MTCT appears to be variable and complex: placental malaria that is controlled at low density may cause an increase in broad-based immune responses that protect against MTCT; uncontrolled, high-density malaria may simultaneously disrupt placental architecture and generate substantial antigen stimulus to HIV replication and increase risk for MTCT. KW - malaria KW - HIV KW - pregnancy KW - vertical disease transmission KW - placenta KW - risk factors KW - Kenya KW - Africa DO - 10.3201/eid1004.030303 UR - https://wwwnc.cdc.gov/eid/article/10/4/03-0303_article ER - End of Reference