title: Intrapartum mucosal exposure to human immunodeficiency virus type 1 (HIV-1) of infants born to HIV-1-infected mothers correlates with maternal plasma virus burden.
abstract: The majority of vertical infections with human immunodeficiency virus type 1 (HIV-1) occur at or near delivery, strongly suggesting a mucosal route of transmission. The frequency and level of intrapartum mucosal exposure to HIV-1 of 22 infants born to infected mothers was investigated. Maternal plasma HIV-1 RNA and CD4 cell count were measured at delivery. Infant oropharyngeal aspirates obtained at birth were examined for HIV-1 RNA by reverse transcription-polymerase chain reaction and qualitative nucleic acid sequence-based amplification. Nine infants (41%) had detectable levels of HIV-1 RNA, 3 of which were quantifiable (mean, 3000 copies/mL). This mucosal exposure to HIV-1 during delivery did not lead to infection of any infant. Cesarian delivery did not reduce mucosal exposure to HIV-1. Mucosal exposure did not correlate with maternal CD4 cell count but did correlate with maternal plasma virus load and was reduced by antiretroviral therapy.
authors.affiliation: Department of Genito-Urinary Medicine, and Communicable Diseases, Jefferiss Research Trust Laboratories, London, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: Ait-Khaled
authors.forename: E G
authors.initials: EG
authors.lastname: Lyall
authors.forename: C
authors.initials: C
authors.lastname: Stainsby
authors.forename: G P
authors.initials: GP
authors.lastname: Taylor
authors.forename: A
authors.initials: A
authors.lastname: Wright
authors.forename: J N
authors.initials: JN
authors.lastname: Weber
authors.forename: M O
authors.initials: MO
authors.lastname: McClure
authors.forename: G
authors.initials: G
authors.lastname: Tudor-Williams
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D002585:Cesarean Section / Q000009:adverse effects; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D009061:Mouth Mucosa / Q000821:virology*; D009960:Oropharynx / Q000821:virology; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology; D012367:RNA, Viral / Q000302:isolation & purification*
chemical_list: D012367:RNA, Viral