Mother-to-infant transmission of human immunodeficiency virus type 1: association with prematurity or low anti-gp120.
In a prospective study of pregnant women infected with human immunodeficiency virus type 1 (HIV-1) in Brooklyn, New York, USA, 16 (29%) of 55 evaluable infants were infected with HIV-1. 9 infants had paediatric acquired immunodeficiency syndrome, 6 had less severe clinical manifestations of HIV-1 infection, and 1 was symptom-free but was seropositive for HIV-1 beyond 15 months of age. The 10 infants born at 37 weeks of gestation or earlier were at higher risk of HIV-1 infection than infants born at 38 weeks of gestation or later (60% vs 22%) but the median age at appearance of disease was approximately 5 months in both groups. The HIV-1 transmission rate was not associated with predelivery levels of maternal T cells, anti-p24, or neutralising antibodies but it was higher, among full-term infants, for those with mothers in the lowest third of the distribution of anti-gp120 levels (53%). On immunoblot, transmitting mothers lacked a gp120 band but not other bands. Protection was not associated with antibody to recombinant peptides from the hypervariable region of the major neutralising gp120 epitope, and the anti-gp120 endpoint dilution titre was similar in transmitting and non-transmitting mothers. Mothers of uninfected full-term infants appear to confer immunological protection against HIV-1 infection of their offspring by way of a high-affinity antibody to a gp120 epitope, whose specificity has importance for vaccine development and possibly perinatal immunotherapy.
Goedert
J J
JJ
Viral Epidemiology Section, National Cancer Institute, Bethesda, Maryland.
Mendez
H
H
Drummond
J E
JE
Robert-Guroff
M
M
Minkoff
H L
HL
Holman
S
S
Stevens
R
R
Rubinstein
A
A
Blattner
W A
WA
Willoughby
A
A
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000276:immunology / Q000635:transmission*; D015153:Blotting, Western; D005260:Female; D015683:Gene Products, gag / Q000276:immunology; D005865:Gestational Age; D015483:HIV Antibodies / Q000032:analysis*; D016655:HIV Core Protein p24; D015699:HIV Envelope Protein gp120 / Q000276:immunology*; D015497:HIV-1 / Q000276:immunology; D006801:Humans; D007124:Immunoenzyme Techniques; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000209:etiology* / Q000276:immunology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology; D011446:Prospective Studies; D011863:Radioimmunoassay; D012307:Risk Factors; D014758:Viral Core Proteins / Q000276:immunology
D015683:Gene Products, gag; D015483:HIV Antibodies; D016655:HIV Core Protein p24; D015699:HIV Envelope Protein gp120; D014758:Viral Core Proteins