The Role of Co-Infections in Mother-to-Child Transmission of HIV
Caroline C. King, Sascha R. Ellington and Athena P. Kourtis
Affiliation: Division of Reproductive Health, NCCDPHP, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, MS-K34, Atlanta, GA 30341, USA.
In HIV-infected women, co-infections that target the placenta, fetal membranes, genital tract, and breast tissue,
as well as systemic maternal and infant infections, have been shown to increase the risk for mother-to-child transmission
of HIV (MTCT). Active co-infection stimulates the release of cytokines and inflammatory agents that enhance HIV
replication locally or systemically and increase tissue permeability, which weakens natural defenses to MTCT. Many
maternal or infant co-infections can affect MTCT of HIV, and particular ones, such as genital tract infection with herpes
simplex virus, or systemic infections such as hepatitis B, can have substantial epidemiologic impact on MTCT. Screening
and treatment for co-infections that can make infants susceptible to MTCT in utero, peripartum, or postpartum can help
reduce the incidence of HIV infection among infants and improve the health of mothers and infants worldwide.
Keywords: Co-infections, HIV, infections, infant, mother-to-child transmission, MTCT, PMTCT, WHO, Candidiasis, screening
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