Maternal and Perinatal Risk Factors Associated with Vertical Transmission of Hiv-1 Infection from Mother to Child

In 2009, the US Centers for Disease Control and Prevention (CDC) estimated that almost 11,000 children younger than 13 years old in the United States were diagnosed with HIV infection. Of those, it is estimated that the vast majority (88%) acquired the HIV infection perinatally. Given that both perinatal transmission is the most common route of HIV infection in children under 13 in the US and that childbirth rates among HIV infected women have increased by approximately 30% in recent years, we can expect additional cases of mother to child HIV transmission (vertical) unless e ective public health interventions are instituted. To do so, it is imperative to gain a better understanding of risk factors associated with vertical transmission of HIV-1 infection. We perform a secondary analysis of data from the Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted HIV1 Infection Study to investigate these factors and to describe di erences in maternal and perinatal characteristics between HIV-1 transmitters and non-transmitters. We employed a bootstrap aggregation procedure using stepwise logistic regression to identify the potentially important predictors of increased HIV-1 transmission. Of the 17 variables we investigated, only CD4-CD8 ratio, vaginal bleeding during pregnancy, AZT used during pregnancy, and ruptured membranes greater than 24 hours were identi ed as signi cant risk factors. Date: December 5, 2014.