Immunoprophylaxis to prevent mother-to-child transmission of HIV-1.
Antiretroviral therapy can profoundly reduce the risk of mother-to-child transmission (MTCT) of HIV, but the drugs have a relatively short half-life and should thus be administered throughout breast-feeding to optimally prevent postnatal infection of the infant. The potential toxicities and the development of resistance may limit the long-term efficacy of antiretroviral prophylaxis, and a safe and effective active/passive immunoprophylaxis regimen, begun at birth, and potentially overlapping with interpartum or neonatal chemoprophylaxis, would pose an attractive alternative. This review draws on data presented at the Ghent Workshop on prevention of breast milk transmission and on selected issues from a workshop specifically relating to immunoprophylaxis held in Seattle in October 2002. This purpose of this review is to address the scientific rationale for the development of passive (antibody) and active (vaccine) immunization strategies for prevention of MTCT. Data regarding currently or imminently available passive and active immunoprophylaxis products are reviewed for their potential use in neonatal trials within the coming 1-2 years.
Safrit
Jeffrey T
JT
Elizabeth Glaser Pediatric AIDS Foundation, David Geffen School of Medicine, University of California, Los Angeles, USA.
Ruprecht
Ruth
R
Ferrantelli
Flavia
F
Xu
Weidong
W
Kitabwalla
Moiz
M
Van Rompay
Koen
K
Marthas
Marta
M
Haigwood
Nancy
N
Mascola
John R
JR
Luzuriaga
Katherine
K
Jones
Samuel Adeniyi
SA
Mathieson
Bonnie J
BJ
Newell
Marie-Louise
ML
D016915:AIDS Vaccines / Q000627:therapeutic use; D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control* / Q000635:transmission*; D000818:Animals; D001942:Breast Feeding / Q000009:adverse effects; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015497:HIV-1; D006801:Humans; D007116:Immunization, Passive; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008895:Milk, Human / Q000821:virology*; D011247:Pregnancy
D016915:AIDS Vaccines; D015483:HIV Antibodies