Transmission of HIV-1 Infections From Mothers to Infants in Haiti
Impact on Childhood Mortality and Malnutrition
- Neal A. Halsey, MD;
- Reginald Boulos, MD, MPH;
- Elizabeth Holt, DrPH;
- Andrea Ruff, MD;
- Jean-Robert Brutus, MD, MPH;
- Patricia Kissinger, MPH;
- Thomas C. Quinn, MD;
- Jacqueline S. Coberly, PhD;
- Mario Adrien, MD;
- Carlo Boulos, MD, MPH;
- The CDS/JHU AIDS Project Team
- From the Department of International Health, School of Hygiene and Public Health (Drs Halsey, Holt, Ruff, and Coberly) and the Department of Medicine, School of Medicine (Dr Quinn), and the Department of Pediatrics (Drs Halsey and Ruff), The Johns Hopkins University, Baltimore, Md; the Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, Bethesda, Md (Dr Quinn); the Centers for Development and Health, Complexe Medico Sociale de la Cité Soleil, Port-au-Prince, Haiti (Drs R. Boulos, Brutus, Adrien, and C. Boulos and Ms Kissinger); and the Centers for Development and Health/Johns Hopkins University AIDS Project Team (the members of the team are listed at the end of this article).
Abstract
Of 4588 pregnant women in a high-risk Haitian population, 443 (9.7%) were serologically positive for the human immunodeficiency virus type 1 (HIV-1). Infants born to women who were HIV-1 seropositive were more likely to be premature, of low birth weight, and malnourished at 3 and 6 months of age than were infants born to women who were HIV-1 seronegative. Increased mortality was observed in infants born to women who were HIV-1 seropositive by 3 months of age. At 12 months of age, 23.4% of the infants born to women who were HIV-1 seropositive had died compared with 10.8% of the infants born to women who were HIV-1 seronegative; at 24 months of age, the mortality rates were 31.3% and 14.2%, respectively. Maternal HIV-1 infections resulted in an 11.7% increase in the overall infant mortality rate in this population. The estimated mother-to-infant HIV-1 transmission rate in these breast-fed infants was 25%, similar to the rates reported for non—breast-fed populations in the United States and Europe.
(JAMA. 1990;264:2088-2092)
Footnotes
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Reprint requests to Department of International Health, School of Hygiene and Public Health, The Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205 (Dr Halsey).
