Abstract
We performed a meta-analysis of the predictive value of maternal cell-free viral load in vertical HIV-1 transmission, including 9 cohorts with 1115 mother-infant pairs (696 untreated and 419 treated women). The pooled rate of transmission in untreated women was 21.3% (95% confidence interval [CI], 18.3%-24.5%). The rates of transmission for untreated women in the <1000 copies/ml, 1000 to 9999 copies/ml, and > or = 10,000 copies/ml categories were 5% (95% CI, 2%-11%), 15% (95% CI, 11%-20%) and 37% (95% CI, 29%-46% by random effects), respectively. The area under the receiver operating characteristic (ROC) curve in individual studies ranged from 0.67 to 1.00. The predictive performance of RNA differed between cohorts in which different percentages of transmitters had RNA values >10,000 copies/ml. When 95% of transmitters have RNA values >1000 copies/ml, 77% of nontransmitters would also have values above this cutoff. Transmission rates for treated women in the 1000 to 9999 copies/ml category (7%; 95% CI, 4%-11%,) and > or = 10,000 copies/ml category (18%; 95% CI, 12%-27%) were probably lower than those for untreated women, whereas the transmission rate for treated women with <1000 copies/ml was 5% (95% CI, 2%-11 %). Thus, the ris...Continue Reading
References
Apr 13, 1991·Lancet·P J EasterbrookD R Matthews
Dec 9, 1989·Lancet·J J GoedertA Willoughby
Jul 1, 1989·Journal of General Internal Medicine·C D MulrowJ A Pugh
Jun 3, 1988·Science·J A Swets
Sep 30, 1995·Lancet·I Loussert-AjakaS Saragosti
Sep 1, 1994·The Journal of Pediatrics·W BorkowskyP T Tao
Nov 3, 1994·The New England Journal of Medicine·E M ConnorR L Jacobson
Aug 16, 1994·Proceedings of the National Academy of Sciences of the United States of America·B WeiserH Burger
Jun 9, 1993·JAMA : the Journal of the American Medical Association·M E St LouisM Oxtoby
Jul 30, 1993·Statistics in Medicine·L E MosesB Littenberg
Oct 1, 1993·Medical Decision Making : an International Journal of the Society for Medical Decision Making·B Littenberg, L E Moses
Feb 28, 1996·JAMA : the Journal of the American Medical Association·R E DickoverY J Bryson
Mar 15, 1996·Science·A S PerelsonD D Ho
Dec 19, 1995·Proceedings of the National Academy of Sciences of the United States of America·G FangB Weiser
May 24, 1996·Science·J W MellorsL A Kingsley
Mar 1, 1996·AIDS·J P IoannidisP R Skolnik
Dec 1, 1996·American Journal of Epidemiology·J P IoannidisJ Lau
Nov 28, 1996·The New England Journal of Medicine·R S SperlingJ L Sullivan
Jan 1, 1997·The Journal of Infectious Diseases·M J MayauxJ Puel
Jan 1, 1997·Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology : Official Publication of the International Retrovirology Association·O CollT Espanol
Apr 12, 1997·Lancet·E R EkpiniA E Greenberg
Mar 1, 1997·Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology : Official Publication of the International Retrovirology Association·A J MelvinR W Coombs
May 1, 1997·The Journal of Infectious Diseases·D N BurnsJ J Goedert
May 1, 1997·Nature Medicine·Y CaoA J Ammann
Jun 15, 1997·Annals of Internal Medicine·J W MellorsC R Rinaldo
Jun 1, 1997·AIDS·A AlaeusJ Albert
Jun 25, 1997·JAMA : the Journal of the American Medical Association·C C CarpenterP A Volberding
Oct 7, 1997·Controlled Clinical Trials·J P IoannidisJ Lau
Oct 27, 1997·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·P A BonisJ Lau
Feb 5, 1998·JAMA : the Journal of the American Medical Association·J P Ioannidis
Citations
Sep 29, 1999·Journal of Medical Virology·J R ClarkeG P Taylor
Jul 27, 2001·Current Infectious Disease Reports·Jaime Deville, Yvonne Bryson
Nov 30, 2000·Current Infectious Disease Reports·M Holodniy
Sep 21, 2001·Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology·W Holmes, T Kwarteng
May 13, 2006·Genes and Immunity·M MontanoM Essex
Apr 1, 1999·The New England Journal of Medicine·UNKNOWN International Perinatal HIV GroupR Tuomala
Apr 1, 1999·The New England Journal of Medicine·L E Riley, M F Greene
Aug 5, 1999·The New England Journal of Medicine·L M MofensonG J Nemo
Dec 28, 1999·The New England Journal of Medicine·J P Ioannidis, D G Contopoulos-Ioannidis
Nov 9, 2002·Journal of Psychoactive Drugs·Samuel A MacMaster, Kenneth A Vail
Apr 20, 2004·AIDS·John P A IoannidisJeffrey Wiener
May 10, 2001·Clinical Obstetrics and Gynecology·M Khoury, A Kovacs
Jan 7, 2003·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Despina G Contopoulos-IoannidisJohn P A Ioannidis
Mar 29, 2006·The Pediatric Infectious Disease Journal·Nelly BriandMarc Lallemant
Feb 19, 2008·The Pediatric Infectious Disease Journal·Charles ChaselaJennifer S Read
Mar 24, 2012·AIDS·Phillip J ReadUNKNOWN London HIV Perinatal Research Group
Mar 13, 2010·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Ying Q ChenJennifer S Read
May 24, 2000·Journal of Virology·G C JohnJ Overbaugh
Mar 31, 2006·Journal of Virology·Jenna RychertAngela Martin Amedee
Aug 17, 1999·Sexually Transmitted Infections·G P TaylorG Tudor-Williams
Feb 26, 2005·Virology Journal·Paul KamaraPauline Jolly
Apr 25, 2001·Journal of Addictive Diseases·R YoastH C Champion
Jul 19, 2001·AIDS Education and Prevention : Official Publication of the International Society for AIDS Education·K SiegelJ K Johnson
Oct 17, 2008·Current Problems in Pediatric and Adolescent Health Care·Jennifer S ReadSusan Schuval
Sep 21, 2011·Journal of Internal Medicine·M Cavarelli, G Scarlatti
Aug 9, 2002·AIDS Research and Human Retroviruses·Anastasia PolycarpouUNKNOWN Ariel Project
Dec 22, 1999·AIDS Research and Human Retroviruses·V ZacharA S Goustin
Oct 16, 2004·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Isis S MikhailPauline E Jolly
Apr 18, 2003·AIDS·Karolynn Siegel, Helen-Maria Lekas
Oct 13, 2006·Current Opinion in Infectious Diseases·G Tudor-Williams, E G Lyall
May 30, 2020·PloS One·Matthew SandbulteSarah Finocchario-Kessler