[Maternal immunity and mother-to-child transmission of HCV and HIV-1: challenges and recent advances].
Human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV) are two viral pathogens that establish chronic infections in their hosts and that are at present responsible for serious public health problems on a pandemic scale. HIV-1 and HCV can be transmitted from person to person by contact with bodily fluids. Both can also be transmitted from mother to child during the course of pregnancy and childbirth. There are currently no vaccines available to immunize against HIV-1 and HCV infection or to prevent mother-to-child transmission (MTCT), and accessible treatments have significant yet limited efficacy. However, important progresses have been made since the discovery of HCV and HIV-1 : (a) sensitive screening and detection methods have been perfected ; (b) risk factors for acquisition, replicative cycles, pathogenesis, and mechanisms of transmission have been better characterized ; (c) specific treatments, immunotherapy, and antiretroviral prophylaxis regimen were developed ; (d) immune correlates of protection are better understood ; and (e) vaccine design was undertaken. In addition, co-infection with HCV and HIV-1, which is common among high-risk groups including injection drug users, significantly increases the incidence of MTCT of both viruses. The mechanisms by which this facilitation occurs are still under investigation and may involve direct replicative facilitation, enhancement of placental transfer, and/or interference with host immune responses. Taken together, these developments could lead to the implementation of global scale strategies to prevent MTCT of HCV and HIV-1.
Ransy
Doris G
DG
Unité d'Immunopathologie virale, Départements de microbiologie et d'Immunologie, Faculté de médecine, Université de Montréal (Québec), Canada.
Akouamba
Bertine S
BS
Samson
Johanne
J
Lapointe
Normand
N
Soudeyns
Hugo
H
D005260:Female; D015658:HIV Infections / Q000150:complications / Q000276:immunology / Q000517:prevention & control / Q000635:transmission*; D015497:HIV-1; D006526:Hepatitis C / Q000150:complications / Q000276:immunology / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology* / Q000821:virology