Vaccines for prevention of mother-to-child transmission of HIV.
OBJECTIVE
This review outlines data available on HIV immunization for the interruption of mother-to-child transmission of HIV. There is a critical need for low cost, safe, and universally accessible methods to interrupt mother-to-child transmission of HIV in utero, intrapartum and though breastfeeding including when the mother acquires HIV infection while breastfeeding her child. Active immunization is the only strategy with this potential.


RESULTS
There are recent findings in three major areas: studies in neonatal macaques, demonstrating encouraging results in terms of providing partial protection from repeat oral SIV and SHIV challenge with active or passive immunization but limited immunologic correlates of protection; safety and immunogenicity of three different canarypox HIV vaccine constructs with and without gp120 envelope subunit boost in infants and studies evaluating the importance of neutralizing antibody in mother-to-child transmission of HIV.


CONCLUSIONS
To protect infants born to HIV-infected women completely an effective prophylactic vaccine is critical. Candidate vaccines tested in this population to date demonstrate safety, tolerability and immunogenicity. Based on the ongoing risk of infection and the tremendous potential for benefit, further studies of candidate vaccines should proceed in this population.
aPediatric Infectious Diseases, Duke University Medical Center, Durham, North Carolina bUniversity of Colorado School of Medicine, Denver, Colorado, USA.
Coleen K
CK
Cunningham
Elizabeth
E
McFarland