ArticlePLoS medicine2006
Maternal-fetal microtransfusions and HIV-1 mother-to-child transmission in Malawi.
Article in PLoS medicine, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- The risk of sexual transmission of HIV in individuals with low-level HIV viraemia: a systematic review.Lancet (London, England) · 2023Pooled it
- Antiretroviral therapy (ART) for treating HIV infection in ART-eligible pregnant women.The Cochrane database of systematic reviews · 2010Pooled it
- Low birth weight and adverse pregnancy outcomes among women living with HIV and HIV-uninfected in Rwanda.PloS one · 2025Article
- Understanding Viral and Immune Interplay During Vertical Transmission of HIV: Implications for Cure.Frontiers in immunology · 2021Review
- Monitoring Prevention Impact of Mother-to-Child Transmission of HIV in Concentrated Epidemics With Program and Survey Data.JMIR public health and surveillance · 2017Article
- The role of cell-associated virus in mother-to-child HIV transmission.The Journal of infectious diseases · 2014Review
- HLA-G 14 bp deletion/insertion polymorphism and mother-to-child transmission of HIV.Tissue antigens · 2014Article
- Short communication: HIV type 1 subtype C variants transmitted through the bottleneck of breastfeeding are sensitive to new generation broadly neutralizing antibodies directed against quaternary and CD4-binding site epitopes.AIDS research and human retroviruses · 2013Article
- Postnatally-transmitted HIV-1 Envelope variants have similar neutralization-sensitivity and function to that of nontransmitted breast milk variants.Retrovirology · 2013Article
- Review
- Elevated cytokine and chemokine levels in the placenta are associated with in-utero HIV-1 mother-to-child transmission.AIDS (London, England) · 2012Article
- HIV-1 Nef breaches placental barrier in rat model.PloS one · 2012Article
- The genetic bottleneck in vertical transmission of subtype C HIV-1 is not driven by selection of especially neutralization-resistant virus from the maternal viral population.Journal of virology · 2011Article
- Different regions of HIV-1 subtype C env are associated with placental localization and in utero mother-to-child transmission.Journal of virology · 2011Article
- The role of HIV replicative fitness in perinatal transmission of HIV.Virologica Sinica · 2011Review
- Acute HIV infection among pregnant women in Malawi.Diagnostic microbiology and infectious disease · 2010Article
- Chikungunya virus infection during pregnancy, Reunion, France, 2006.Emerging infectious diseases · 2010Article
- Antibody-dependent transplacental transfer of malaria blood-stage antigen using a human ex vivo placental perfusion model.PloS one · 2009Article
- Functional genetic variants in DC-SIGNR are associated with mother-to-child transmission of HIV-1.PloS one · 2009Article
- Maternal-fetal DNA admixture is associated with intrapartum mother-to-child transmission of HIV-1 in Blantyre, Malawi.The Journal of infectious diseases · 2008Article
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Authors and funding
9 authors at 5 institutions in 4 countries.
Funding
Abstract
backgroundBetween 25% and 35% of infants born to HIV-infected mothers become HIV-1 infected. One potential route of mother-to-child transmission (MTCT) could be through a breakdown in the placental barrier (i.e., maternal-fetal microtransfusions). METHODS AND
findingsPlacental alkaline phosphatase (PLAP) is a 130-kD maternal enzyme that cannot cross the intact placental barrier. We measured PLAP activity in umbilical vein serum as an indicator of maternal-fetal microtransfusion, and related this to the risk of HIV-1 MTCT. A case-cohort study was conducted of 149 women randomly selected from a cohort of HIV-1-infected pregnant Malawians; these women served as a reference group for 36 cases of in utero MTCT and 43 cases of intrapartum (IP) MTCT. Cord PLAP activity was measured with an immunocatalytic assay. Infant HIV status was determined by real-time PCR. The association between cord PLAP activity and HIV-1 MTCT was measured with logistic regression using generalized estimating equations. Among vaginal deliveries, PLAP was associated with IP MTCT (risk ratio, 2.25 per log10 ng/ml PLAP; 95% confidence interval, 0.95-5.32) but not in utero MTCT. In a multivariable model adjusted for HIV-1 RNA load, chorioamnionitis, and self-reported fever, the risk of IP MTCT almost tripled for every log10 increase in cord PLAP activity (risk ratio, 2.87; 95% confidence interval, 1.05-7.83).
conclusionThese results suggest that during vaginal deliveries, placental microtransfusions are a risk factor for IP HIV-1 MTCT. Future studies are needed to identify factors that increase the risk for microtransfusions in order to prevent IP HIV-1 MTCT.
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