Affiliations: Department of Population and Family Health Sciences,
Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD,
USA | Uganda Virus Research Institute, Entebbe, Uganda | School of Public Health, Makerere University, Kampala,
Uganda | Institute of Public Health, Makerere University,
Kampala, Uganda | School of Medicine, Makerere University, Kampala,
Uganda
Note: [] Correspondence: Heena Brahmbhatt, PhD, Department of Population
and Family Health Sciences, Johns Hopkins University, Bloomberg School of
Public Health, E4539, 615 N. Wolfe St. Baltimore, MD 21205, USA. Tel.: +1 443
287 4928; Fax: +1 410 614 7386; E-mail: hbrahmbh@jhsph.edu
Abstract: Purpose: To assess gender differences in the risk of mother-to-child
transmission (MTCT) of human immunodeficiency virus (HIV). HIV-positive mothers
were identified from a population cohort followed from 1994 to 2000. HIV
infection in mothers was detected using two independent enzyme immunoassays and
infant HIV infection was diagnosed using RNA- polymerase chain reaction. Birth
weight was determined by anthropometry. Logistic regression was used to assess
the univariate and multivariate risk factors of MTCT. Approximately 16% of 371
infants were HIV-positive in the in-utero and intrapartum periods and an
additional 16% were infected via breastfeeding. Female infants were
significantly more likely to be HIV infected perinatally compared with male
infants (20.8% vs. 12.4%, respectively, P = 0.035), but there was no
significant sex differences in postnatal risk of MTCT. In adjusted analyses,
among mothers with higher than median HIV viral loads, there was no significant
difference in the risk of MTCT by gender, but among mothers with lower than
median HIV viral loads, female infants were significantly more likely to be HIV
infected (odds ratio = 4.1, confidence interval = 1.04–16.1). Low birth
weight was more frequent in female than male infants born to HIV-positive
mothers. Female infants could be more susceptible to HIV infection in the
in-utero and peripartum period compared with male infants. Alternatively, this
sex association could be due to higher in-utero mortality rates of male infants
or to increased susceptibility of female infants.
