Safer pregnancy. Treating pregnant women with HIV to malaria can reduce the risk of transmitting the virus to the child, a study suggests.
for the first time, a study of pregnant women infected with HIV found that co-infection with malaria has significantly increased the risk of transmission of the AIDS virus her child before or during birth of a mother. According to a report in the November issue of AIDS , some of these pregnant women in Uganda had nearly three times the risk of transmitting the AIDS virus to their babies.
Little is know about how other diseases affect the chances of a mother passing HIV to her fetus. To assess the risk for malaria, epidemiologist at Johns Hopkins University Heena Brahmbhatt turned to a set of data from a large study by his adviser, Ronald Gray, in collaboration with several Ugandan research groups. These researchers assessed 746 pregnant women with HIV and their babies in the Rakai district of Uganda from 1994 to 1999. Brahmbhatt found 93 cases in which the researchers recorded the HIV status of the child and had also retained placenta. Of the 15 babies whose mothers had placental malaria, she found that six (40%) were infected. However, the spread of HIV in only 12 of the 78 infants (15%) whose infected mother has not had malaria in their placentas.
The results were statistically significant, leading the authors to conclude that the tests are "urgently needed" to assess whether drugs against malaria can reduce HIV transmission to the fetus. "If our findings pan out, there may be a case for the removal of malaria much more aggressive in women infected with HIV during pregnancy," says Gray.
The story is complicated, however. Another study, in press at Emerging Infectious Diseases , found that the number of parasites in the placenta is crucial: Low levels actually offer some protection against HIV, while higher levels are increasing risk, said lead investigator of the study, Richard Steketee of the US Centers for Disease Control and Prevention in Atlanta. Gray Hopkins said he and his colleagues plan to check the levels of parasites in the placenta of Uganda.
Steketee suspects that the intensity of malaria infection alters the immunity of the mother in various ways, affecting the ability of HIV to be transmitted in utero. "It would be important for someone to look at this time," said Steketee. "These are not easy studies and they are not cheap, but the impact could be considerable."
Related Sites
The mother-child transmission of overflight of HIV from the World of the Organization Health
Roll Back Malaria, malaria during pregnancy
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