title: Viral sequence analysis of HIV-positive women and their infected children: insight on the timing of infection and on the transmission network.
abstract: We used high-resolution phylogenetic methods in the context of mother-to-child transmission to obtain information on the timing of the infection and on the transmission network. A total of 33 pol sequences (from maternal peripheral blood, from breast milk, and from plasma of children) belonging to five cases of HIV infant transmission were studied. Using time-scaled phylogeny we were able to estimate that in two cases the transmission occurred after the recommended duration of breastfeeding, supporting a longer, not reported, duration of breastfeeding as a significant factor associated with HIV infant acquisition in this cohort. Among the postnatal infections we were also able to demonstrate that the cell-free virus in breast milk was the most likely population associated with the event of transmission. Our study showed that a coalescent-based model within a Bayesian statistical framework can provide important information that can contribute to optimizing preventive strategies.
authors.affiliation: 1 Department of Infectious, Parasitic, and Immune-Mediated Diseases, Epidemiology Unit, Reference Centre on Phylogeny, Molecular Epidemiology, and Microbial Evolution (FEMEM), Istituto Superiore di Sanità , Rome, Italy .
authors.forename: Massimo
authors.initials: M
authors.lastname: Ciccozzi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Lo Presti
authors.forename: Mauro
authors.initials: M
authors.lastname: Andreotti
authors.forename: Sandro
authors.initials: S
authors.lastname: Mancinelli
authors.forename: Susanna
authors.initials: S
authors.lastname: Ceffa
authors.forename: Clementina Maria
authors.initials: CM
authors.lastname: Galluzzo
authors.forename: Ersilia
authors.initials: E
authors.lastname: Buonomo
authors.forename: Richard
authors.initials: R
authors.lastname: Luhanga
authors.forename: Haswell
authors.initials: H
authors.lastname: Jere
authors.forename: Eleonora
authors.initials: E
authors.lastname: Cella
authors.forename: Paola
authors.initials: P
authors.lastname: Scarcella
authors.forename: Marco
authors.initials: M
authors.lastname: Mirra
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Marazzi
authors.forename: Stefano
authors.initials: S
authors.lastname: Vella
authors.forename: Leonardo
authors.initials: L
authors.lastname: Palombi
authors.forename: Marina
authors.initials: M
authors.lastname: Giuliano
mesh_terms: D000328:Adult; D002648:Child; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000635:transmission / Q000821:virology*; D015497:HIV-1 / Q000145:classification / Q000235:genetics*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D010802:Phylogeny
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