Weiser B, Fang G, Tropper P, Nachman S, Grimson R, Reyelt C, Hutcheon N, Burger H; HIV Infection in Women Conference.
Program Abstr HIV Infect Women Conf HIV Infect Women Conf 1995 Wash DC. 1995 Feb 22-24; S20.
Wadsworth Ctr., NYS Dept. of Health, Albany, NY.
To develop strategies to prevent mother-to-child HIV-1 transmission, it is important to identify its determinants. Because HIV-1 RNA levels in plasma can be reduced by antiviral therapy, we determined the relationship of maternal plasma HIV-1 RNA level to the occurrence of mother- to-child transmission. We also determined serial HIV-1 RNA levels in pregnant women who received antiviral therapy and those who did not. We used RT QC-PCR to rigorously quantitate plasma HIV-1 RNA levels in 30 pregnant women and followed their infants prospectively. 8 of 30 mothers (27%) transmitted to their infants and plasma RNA level at delivery correlated strikingly with transmission. Although 8 of 10 mothers with the highest HIV-1 RNA levels in plasma transmitted, none of the 20 mothers with lower levels did (P less than .0004). Serial viral RNA levels remained stable in women who were untreated and in those who continued with the same therapeutic regimen; changes in viral load after initiation of treatment varied according to treatment regimen. These findings indicate that maternal plasma HIV-1 titer is a major determinant of mother-to-child transmission and that viral titer remains stable during pregnancy. They provide the scientific underpinnings for counseling of HIV- 1-infected women of child-bearing age. These two related results suggest that determination of plasma HIV-1 titer early in pregnancy may predict which women are most likely to transmit to their infants. These data also provide a strong scientific rationale for implementing multiple strategies interrupt transmission by reducing viral load.
Publication Types:
Keywords:
- AIDS Vaccines
- Acquired Immunodeficiency Syndrome
- Antiviral Agents
- Child
- DNA Primers
- Delivery, Obstetric
- Disease Transmission, Vertical
- Female
- HIV Infections
- HIV Seropositivity
- HIV-1
- Humans
- Infant
- Mothers
- Polymerase Chain Reaction
- Pregnancy
- Pregnancy Complications, Infectious
- RNA, Viral
- Viral Load
- surgery
- transmission
Other ID:
UI: 102214772
From Meeting Abstracts