HIV Vertical Transmission Rate Determinations Are Subject to Differing Definitions and Therefore Different Rates

Pitt, Jane; Goldfarb, Johanna; Schluchter, Mark; Kovacs, Andrea; Cooper, Ellen; Hodes, David; McIntosh, Kenneth; Peavy, Hannah; Shearer, William; for the Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted HIV Infection Study Group,

« Previous Next »Journal of Clinical Epidemiology
Volume 51, Issue 2 , Pages 159-164, February 1998

HIV Vertical Transmission Rate Determinations Are Subject to Differing Definitions and Therefore Different Rates

Jane Pitt
- Department of Pediatrics, Columbia University College of Physicians And Surgeons, New York, New York USA
Johanna Goldfarb
- Division of Pediatric and Adolescent Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio USA
Mark Schluchter
- Department of Biostatistics and Epidemiology, The Cleveland Clinic Foundation, Cleveland, Ohio USA
- Mark D. Schluchter, Ph.D., Department of Biostatistics, Desk P-88, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, Cleveland OH 44195
Andrea Kovacs
- Department of Pediatrics, Division of Pediatric Infectious Disease, LA County/USC Medical Center, Los Angeles, California USA
Ellen Cooper
- Department of Pediatric Infectious Disease, Boston City Hospital, Boston, Massachusetts USA
David Hodes
- Department of Pediatrics, Mount Sinai School of Medicine, New York, New York USA
Kenneth McIntosh
- Division of Infectious Disease, The Children's Hospital, Boston, Massachusetts USA
Hannah Peavy
- Division of Lung Diseases, National Heart, Lung and Blood Institute, Bethesda, Maryland USA
William Shearer
for the Pediatric Pulmonary and Cardiovascular Complications of Vertically Transmitted HIV Infection Study Group
- Department of Allergy and Immunology, Texas Children's Hospital/Baylor College of Medicine, Houston, Texas USA

Accepted 7 October 1997.

Abstract

The HIV infection status of a cohort of 600 prospectively followed children born to HIV infected mothers was determined using HIV peripheral blood culture tests at 0, 3, and 6 months of age, HIV serology at ≥15 months, and CDC AIDS criteria. We estimated transmission rates using five methods which differed in how HIV indeterminates are handled. These methods were applied at two points in time to illustrate effects of length of follow-up of the cohort on results. In January 1997, 30 months after the last birth, transmission rate estimates ranged from 15.5% (known positives/known positives × known negatives) to 18.1% (known positives × those with one positive culture × deaths/entire cohort minus those lacking negative cultures at age ≥5 months). Estimates ranged from 14.8% to 20.7% using the subcohort of 284 children followed ≥12 months as of May 1993. These results indicate that methods for assigning HIV infection status and for handling HIV indeterminates should be carefully defined when estimating transmission rates.

Keywords: HIV, vertical transmission, pediatric AIDS