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.
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.
Ait-Khaled
M
M
Department of Genito-Urinary Medicine, and Communicable Diseases, Jefferiss Research Trust Laboratories, London, United Kingdom.
Lyall
E G
EG
Stainsby
C
C
Taylor
G P
GP
Wright
A
A
Weber
J N
JN
McClure
M O
MO
Tudor-Williams
G
G
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*
D012367:RNA, Viral