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M9490366.TXT
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1994-09-19
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Document 0366
DOCN M9490366
TI Quantitation of human immunodeficiency virus type 1 during pregnancy:
relationship of viral titer to mother-to-child transmission and
stability of viral load.
DT 9411
AU Weiser B; Nachman S; Tropper P; Viscosi KH; Grimson R; Baxter G; Fang G;
Reyelt C; Hutcheon N; Burger H; Wadsworth Center, New York State
Department of Health, Albany; 12208.
SO Proc Natl Acad Sci U S A. 1994 Aug 16;91(17):8037-41. Unique Identifier
: AIDSLINE MED/94336681
AB To develop strategies to prevent mother-to-child transmission of human
immunodeficiency virus type 1 (HIV-1), it is important to define the
factors determining it. We examined the relationship between maternal
HIV-1 titer and the occurrence of mother-to-child transmission. In
addition, we quantitated HIV-1 longitudinally in mothers during
pregnancy, at delivery, and up to 1 year postpartum. To examine
transmission, we prospectively studied 19 mother-child pairs; in 5
pairs, HIV-1 transmission occurred. We used endpoint dilution culture of
peripheral blood mononuclear cells to determine maternal viral titer and
found that although 4 of 6 (67%) women with viral titers of > or = 125
HIV-1 infectious units per 10(6) cells transmitted HIV-1 to their
infants, only 1 of 13 (7.6%) women with lower viral titers transmitted
(P = 0.01). Twelve of the 19 mothers had HIV-1 loads determined serially
3-8 times over periods ranging from 18 to 65 weeks. Viral titers varied
greatly between the 12 women, but the viral load in each woman remained
stable over time. In this cohort, HIV-1 viral load remained stable
during pregnancy and the greater the maternal viral burden, the more
likely that transmission occurred. These two related findings suggest
that determination of HIV-1 titers early in pregnancy may predict which
women are at high risk of transmitting to their infants and may be used
to counsel HIV-1-infected women of childbearing age. These data identify
maternal viral titer as a major determinant of mother-to-child HIV-1
transmission and thereby provide the scientific rationale for
therapeutic strategies designed to interrupt transmission by lowering
viral load.
DE Acquired Immunodeficiency Syndrome/MICROBIOLOGY/*TRANSMISSION Adult
Base Sequence DNA Primers Female Gestational Age Human HIV
Seropositivity HIV-1/*ISOLATION & PURIF Infant, Newborn
*Maternal-Fetal Exchange Molecular Sequence Data Oligonucleotides,
Antisense Polymerase Chain Reaction/*METHODS Pregnancy Pregnancy
Complications, Infectious/*MICROBIOLOGY Prospective Studies Puerperal
Disorders/MICROBIOLOGY Support, Non-U.S. Gov't Support, U.S. Gov't,
P.H.S. JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).