title: Mother-to-child transmission in the United States of subtypes D and A/G human immunodeficiency virus type 1.
abstract: In the United States and Western Europe, most human immunodeficiency virus type 1 (HIV-1) infections are caused by subtype B. We analyzed the nucleotide sequence of HIV-1 RNA in plasma samples from 141 children enrolled into PACTG 377, a comparative study of several antiretroviral therapy regimens. Phylogenetic analysis revealed that two children, both born in the United States, were infected with non-B subtypes that are most commonly found in Africa: one with subtype D and the other with circulating recombinant form CRF02, an A/G recombinant lineage. Viral load assays performed to monitor treatment response underestimated the levels of HIV-1 RNA in the child with the A/G recombinant. These cases demonstrate mother-to-child transmission of non-B subtypes of HIV-1 in the United States. Non-B subtypes should be considered in the management of HIV-1-infected pregnant women and children to optimize strategies to prevent and treat pediatric HIV-1 infection.
authors.affiliation: Department of Pediatrics, University of California-Los Angeles School of Medicine, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA. pkrogstad@mednet.ucla.edu
authors.forename: Paul
authors.initials: P
authors.lastname: Krogstad
authors.forename: Susan H
authors.initials: SH
authors.lastname: Eshleman
authors.forename: Yongzhi
authors.initials: Y
authors.lastname: Geng
authors.forename: J Brooks
authors.initials: JB
authors.lastname: Jackson
authors.forename: Michael
authors.initials: M
authors.lastname: Wantman
authors.forename: Bette
authors.initials: B
authors.lastname: Korber
authors.forename: Dorothy
authors.initials: D
authors.lastname: Lang
authors.forename: Andrew
authors.initials: A
authors.lastname: Wiznia
authors.forename: George
authors.initials: G
authors.lastname: Johnson
authors.forename: Sharon
authors.initials: S
authors.lastname: Nachman
authors.forename: Paul
authors.initials: P
authors.lastname: Palumbo
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000635:transmission*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D015497:HIV-1 / Q000145:classification*; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D010802:Phylogeny; D011247:Pregnancy; D011446:Prospective Studies; D019562:Viral Load