Vertical transmission of HIV-1: lack of detectable virus in peripheral blood cells of infected children at birth.
OBJECTIVE
To evaluate the time-course of HIV-1 detection in peripheral blood mononuclear cells (PBMC) from newborns at risk of vertically acquired infection.


METHODS
Forty-six infants born to HIV-1-infected mothers were enrolled at birth and examined virologically and clinically in the perinatal period and every 30 days for the first 3 months of life. Follow-up was conducted at intervals of 2-3 months. HIV-1 detection in PBMC was performed using virus culture and polymerase chain reaction (PCR) assay.


RESULTS
Only one out of 24 newborns tested within 48 h of delivery and two out of 22 infants tested between 3 and 15 days of age were found to be HIV-1-positive by both PCR and virus culture. Further testing performed between 30 and 60 days of life identified an additional eight HIV-1-positive children. Subsequent viral, immunological and clinical follow-up confirmed PCR and virus culture results obtained in 30-60-day-old children.


CONCLUSIONS
Infected infants had detectable levels of HIV-1 in their PBMC at 1 month of age. The negative PCR and virus culture findings in PBMC of newborns indicate strongly that HIV-1 cannot be diagnosed at birth in the majority of cases, and suggests that viral transmission could occur during late pregnancy and/or delivery.
De Rossi
A
A
Institute of Oncology, InterUniversity Centre for Cancer Research, Padova, Italy.
Ometto
L
L
Mammano
F
F
Zanotto
C
C
Giaquinto
C
C
Chieco-Bianchi
L
L
D000914:Antibodies, Viral / Q000032:analysis; D001775:Blood Circulation; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007963:Leukocytes, Mononuclear / Q000382:microbiology*; D016389:Maternal-Child Nursing; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D013997:Time Factors
D000914:Antibodies, Viral