Document 0045
 DOCN  M94A0045
 TI    Immune-based interventions in perinatal human immunodeficiency virus
       infection.
 DT    9412
 AU    Connor EM; McSherry G; Department of Pediatrics, University of Medicine
       and Dentistry,; New Jersey Medical School, Children's Hospital of New
       Jersey,; Newark 07103-2714.
 SO    Pediatr Infect Dis J. 1994 May;13(5):440-8. Unique Identifier : AIDSLINE
       MED/94352736
 AB    Essentially all new cases of human immunodeficiency virus (HIV)
       infection in infants and young children occur as a consequence of
       exposure to HIV either in utero, intrapartum or postpartum during breast
       feeding. Currently it is estimated that the majority of vertical
       transmission of HIV occurs at or near the time of birth. Based on what
       is known about the biology of perinatal HIV transmission, the HIV burden
       of the mother, effectiveness of her immune response and that of her
       fetus/infant and the integrity of the placental barrier are likely to
       play important roles in this process. The role of impaired immunologic
       control of HIV is gaining recognition as a potential key element in the
       pathophysiology of perinatal HIV transmission. In most studies to date,
       advanced maternal disease and low CD4 lymphocyte count have been
       associated with increased risk of vertical HIV transmission. In addition
       some studies have indicated that low maternal titers of antibodies to
       certain V3 loop epitopes may have a similar effect on vertical
       transmission. Cellular immune responses, which are known to play an
       important role in host defense against HIV, appear to be impaired in
       infants after exposure to HIV, especially those responses involving the
       development of cytotoxic lymphocytes. Mounting evidence suggests that
       enhancement of humoral and/or cellular immune responses in pregnant
       women and exposed infants is a logical and potentially feasible approach
       to interruption of perinatal transmission (an approach similar to that
       utilized for perinatally acquired hepatitis B virus infection). Studies
       are now in progress to assess HIV hyperimmune globulin and envelope HIV
       vaccines in pregnant woman and HIV-exposed infants.
 DE    AIDS Vaccines/IMMUNOLOGY  Cytokines/THERAPEUTIC USE  Female  Human  HIV
       Infections/*PREVENTION & CONTROL/*TRANSMISSION  Immunization, Passive
       Immunoglobulins, Intravenous/THERAPEUTIC USE  Infant, Newborn  Pregnancy
       *Pregnancy Complications, Infectious  Zidovudine/THERAPEUTIC USE
       JOURNAL ARTICLE  REVIEW  REVIEW, TUTORIAL

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