AEGiS-08IAC: High risk of HIV-1 infection for first-born twin: the role of intra-partum transmission. The International Registry of HIV-exposed twins.

8th International AIDS Conference


Amsterdam, Netherlands — July 19-24, 1992

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High risk of HIV-1 infection for first-born twin: the role of intra-partum transmission. The International Registry of HIV-exposed twins.

Int Conf AIDS 1992 Jul 19-24; 8:We56 (abstract no. WeC 1062)
Duliege AM, Felton S, Goedert JJ; Genentech, So. San Francisco, CA.

OBJECTIVES: To update our previous report on twins (Lancet 1991;338:1471), with emphasis on genetic and intrapartum factors.

METHOD: 50 investigators in 11 countries contributed demographic, clinical and epidemiological retrospective data on 147 sets of twins and 2 sets of triplets. Data were analyzed by McNemar's test for the match twin pairs, Kaplan-Meier survival curves, and Logrank test.

RESULTS: In the 92 sets that could be assessed for HIV-infection, neither twin was infected in 49 (53%) sets, both were infected in 13 (14%), only the 1st-born in 23 (25%), and only the 2nd-born in 7 (8%). By mode of delivery: TABULAR DATA, SEE ABSTRACT VOLUME. 16/19 (84%) of the monozygotic sets were concordant for HIV status, as compared to 40/64 (62%) of the dizygotic sets. When both twins were infected, CDC stage was discordant in only 2/13 sets, both of which were dizygotic. AIDS-free survival rates were similar for the 36 1st-born twins (45% +/- 10%) and for the 20 2nd-born twins (35% +/- 13%); so was their median age at onset of AIDS: 43 months and 34 months respectively, p = .97.

CONCLUSION: 1) Twins Registry data continue to show lower concordance for HIV status among dizygotic than monozygotic twins, and a higher risk of HIV-infection for 1st-born than for 2nd-born twins, apparently by proximity to the birth canal. Possibly beneficial non-invasive procedures ("cleansing the birth canal", suctioning the mouth and the nose) should be evaluated. 2) The progression of HIV disease is similar in 1st-born and 2nd-born twins.

Keywords: AEGIS, HIV Infections, Risk, Twins, Monozygotic, Registries, Acquired Immunodeficiency Syndrome, Delivery, Obstetric, Triplets, Retrospective Studies, Centers for Disease Control and Prevention (U.S.), Female, transmission, surgery, ICA8KWDaegis,hivinfections,risk,twins,monozygotic,registries,acquiredimmunodeficiencysyndrome,delivery,obstetric,triplets,retrospectivestudies,centersfordiseasecontrolandprevention(uKWDsKWD),female,transmission,surgery,ica8
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WeC1062

Copyright © 1992 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.