Mother-Child Transmission of HIV-1 and Infant Survival in Brazzaville, Congo

This study compared the probability of survival of infants born to anti-HIV-1 positive and anti-HIV-1 negative mothers. 1833 pregnant women recruited sequentially in 2 mother-child clinics in Brazzaville were screened for anti-HIV-1 (by enzyme-linked immunosorbent assay with confirmation by western blot). Each seropositive mother (71 of 1833 3.9%) was matched for age presumed date of delivery and place of residence with 2 seronegative mothers. 64 babies born to anti-HIV-1 positive mothers and 130 control babies born to anti-HIV-1 negative mothers were followed for 12-22 months (mean=18 months). The probabilities of survival were estimated by the Kaplan-Meier method. At birth the 2 groups of babies did not differ with regard to rate of stillbirths gestational age sex ratio and weight. Among babies born to seropositive mothers the probability of survival was 0.87 (SD 0.04) at 3 months 0.71 (SD 0.06) at 6 months 0.68 (SD 0.06) at 9 months and 0.61 (SD 0.06) at 12.5 months. In the controls the probability of survival was 0.98 (SD 0.01) at 3 months and 0.97 (SD 0.02) at 12 months. The excess of mortality in the babies born to anti-HIV-1 positive mothers is highly significant (p<0.001). The deaths occurred more often and earlier than in similar cohort studies performed in developed countries. (authors)