Syphilis in HIV-infected Mothers and Infants

作者：Nava Yeganeh, Heather Watts, Margaret Camarca, Gabriel Soares, Esaú João, José Henrique Pilotto, Glenda Gray, Gerhard Theron, Breno Santos, Rosana Fonseca, Régis Kreitchmann, Jorge Pinto, Marisa Márcia Mussi‐Pinhata, Mariana Ceriotto, Daisy Maria Machado, Valdiléa G. Veloso, Beatriz Grinzstejn, Mariza Gonçalves Morgado, Yvonne Bryson, Lynne Mofenson, Karin Nielsen-Saines · 发表于：The Pediatric Infectious Disease Journal · 年份：2014 · DOI：10.1097/inf.0000000000000578 · 被引用次数：74 · 研究领域：Syphilis Diagnosis and Treatment、HIV/AIDS Research and Interventions、Reproductive tract infections research

BACKGROUND: Untreated syphilis during pregnancy is associated with spontaneous abortion, stillbirth, prematurity and infant mortality. Syphilis may facilitate HIV transmission, which is especially concerning in low- and middle-income countries where both diseases are common. METHODS: We performed an analysis of data available from NICHD/HPTN 040 (P1043), a study focused on the prevention of intrapartum HIV transmission to 1684 infants born to 1664 untreated HIV-infected women. This analysis evaluates risk factors and outcomes associated with a syphilis diagnosis in this cohort of HIV-infected women and their infants. RESULTS: Approximately, 10% of women (n=171) enrolled had serological evidence of syphilis without adequate treatment documented and 1.4% infants (n=24) were dually HIV and syphilis infected. Multivariate logistic analysis showed that compared with HIV-infected women, co-infected women were significantly more likely to self-identify as non-white (adjusted odds ratio [AOR] 2.5, 95% CI: 1.5-4.2), to consume alcohol during pregnancy (AOR 1.5, 95% CI: 1.1-2.1) and to transmit HIV to their infants (AOR 2.1, 95% CI: 1.3-3.4), with 88% of HIV infections being acquired in utero. As compared with HIV-infected or HIV-exposed infants, co-infected infants were significantly more likely to be born to mothers with venereal disease research laboratory titers≥1:16 (AOR 3, 95% CI: 1.1-8.2) and higher viral loads (AOR 1.5, 95% CI: 1.1-1.9). Of 6 newborns with symptomatic syphilis,...