title: Antibodies for prevention of mother-to-child transmission of HIV-1.
abstract: OBJECTIVE
  Although antiretroviral (ARV) prophylaxis can reduce mother-to-child transmission (MTCT) of HIV-1 to less than 2%, one-quarter of a million infants continue to be infected with HIV-1 annually. ARV prophylaxis alone will fail to eliminate infant HIV-1 infection because of issues of maternal adherence, toxicities, ARV-resistant virus strains, and acute maternal infection. Effective maternal and/or infant immunization will likely be required to achieve the goal of an HIV-free generation.
  
  
  RESULTS
  This article describes recent studies of antibody responses that protect against vertical HIV-1 transmission. Studies have shown that maternal neutralization breadth is not a critical factor in MTCT, yet the ability of maternal plasma to neutralize autologous virus variants may be important in infant protection. There is also new evidence that infants mount robust and durable antibody responses to HIV-1 envelope following vaccination and can develop broad neutralization during infection. Finally, passive immunization of infants with highly potent and broad neutralizing antibodies may be an effective strategy to protect infants against infection with postnatally transmitted variants.
  
  
  CONCLUSIONS
  Defining the characteristics of maternal and infant antibody responses that protect against MTCT will inform development of effective passive and active immunization strategies that will likely be required to eliminate pediatric HIV-1.
authors.affiliation: aDepartment of Pediatrics bHuman Vaccine Institute, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Genevieve G
authors.initials: GG
authors.lastname: Fouda
authors.forename: M Anthony
authors.initials: MA
authors.lastname: Moody
authors.forename: Sallie R
authors.initials: SR
authors.lastname: Permar
mesh_terms: D005260:Female; D015483:HIV Antibodies / Q000276:immunology*; D015658:HIV Infections / Q000276:immunology / Q000517:prevention & control / Q000635:transmission / Q000821:virology; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology / Q000517:prevention & control / Q000821:virology
chemical_list: D015483:HIV Antibodies