Vertical transmission of human immunodeficiency virus type 1: autologous neutralizing antibody, virus load, and virus phenotype.
OBJECTIVE
To evaluate immunologic and virologic correlates of vertical transmission of human immunodeficiency virus type 1 (HIV-1).


METHODS
Case-control study.


METHODS
Women who were prospectively enrolled in a natural history study of HIV-1 infection in women and infants. Sixteen HIV-1-infected women whose infants became infected were matched by CD4+ cell percentage and use of zidovudine during pregnancy with women whose infants did not become infected.


METHODS
Maternal autologous neutralizing antibody, virus load determined by RNA-polymerase chain reaction (RNA-PCR), and virus phenotype.


RESULTS
Most women in both groups had low titers of autologous neutralizing antibody, and no difference in neutralizing titers was observed (range, < 4 to 181 in both groups). The HIV-1 copy number in maternal plasma was not significantly different in the two groups but was inversely correlated with maternal CD4+ cell percentage (p < 0.005). Five women in the transmitting group and four in the non-transmitting group had syncytium-inducing (SI) phenotype virus. Two infected infants had SI phenotype virus. The SI phenotype virus was associated with a greater HIV-1 copy number in maternal plasma (p < 0.05) and an increase in the mortality rate for the infants (p < 0.01).


CONCLUSIONS
In women matched for CD4+ cell percentage, low titers of autologous neutralizing antibody, high virus load, and SI phenotype virus were not associated with an increased risk of transmission of HIV-1 to their infants.
Husson
R N
RN
Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts 02115, USA.
Lan
Y
Y
Kojima
E
E
Venzon
D
D
Mitsuya
H
H
McIntosh
K
K
D000163:Acquired Immunodeficiency Syndrome / Q000401:mortality / Q000635:transmission*; D018791:CD4 Lymphocyte Count; D005260:Female; D015483:HIV Antibodies / Q000032:analysis*; D016655:HIV Core Protein p24 / Q000032:analysis; D015497:HIV-1 / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D010641:Phenotype; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis
D015483:HIV Antibodies; D016655:HIV Core Protein p24; D012367:RNA, Viral