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).