The inter-relation of maternal immune competence, HIV-1 viral load, and nutritional status in preventing vertical transmission: an alternative to chemoprophylaxis?
As the human immunodeficiency virus (HIV) global pandemic moves towards the end of its second decade, women of reproductive age throughout the world have been shown to be increasingly at risk for acquiring HIV-1 infection. Recently, the focus for preventive measures has expanded to include preventing the perinatal transmission of HIV-1 to fetuses and newborns. This manuscript reviews the available literature that examines risk factors for perinatal transmission, immunopathogenesis of HIV-1 infection, and the role that antioxidant micronutrients play in modulating immune response to HIV-1 disease progression. The available information provides a compelling case for the design of studies that evaluate the extent to which maternal HIV-1 viremia and disease progression are modulated by her nutritional status. Should results from these studies confirm that antioxidant micronutrient status is inversely related to HIV-1 RNA load, particularly in economically vulnerable populations, carefully designed and executed supplementation trials would be warranted.
Moran
P J
PJ
Department of Epidemiology, University of Washington, School of Public Health and Community Medicine, Seattle 98195, USA.
Welles
S L
SL
Williams
M A
MA
D019380:Anti-HIV Agents / Q000627:therapeutic use; D000975:Antioxidants / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D007121:Immunocompetence; D018445:Infectious Disease Transmission, Vertical; D009752:Nutritional Status; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology*; D014621:Vagina / Q000821:virology; D019562:Viral Load; D015215:Zidovudine / Q000627:therapeutic use
D019380:Anti-HIV Agents; D000975:Antioxidants; D015215:Zidovudine