Perinatal transmission of HIV-1: lack of detectable virus in peripheral blood cells at birth, and prognostic values of polymerase chain reaction results in infants.
Int Conf AIDS 1992 Jul 19-24; 8:We56 (abstract no. WeC 1060) De Rossi A, Ometto L, Mammano F, Zanotto C, Giaquinto C, Chieco-Bianchi L; Dept of Pediatrics, University of Padova, Italy.
OBJECTIVE. To assess early diagnosis of perinatal HIV-1 infection, and define prognostic markers for AIDS onset. METHODS. Virus culture was performed by culturing patient peripheral blood mononuclear cells (PBMC) with normal PHA-stimulated PBMC. HIV-1 copy number was determined by direct Polymerase chain reaction (PCR) in lysed patient cells using env and LTR HIV-1 specific primers. Amplified products were quantified by densitometer analysis, and copy number was estimated on a reference curve obtained with 8E51 cells containing 1 provirus/cell. RESULTS. 46 children born to HIV-1 seropositive mothers were studied since birth; none was breast-fed. Only 1 out of 24 newborns tested within 48 hours of delivery (group A) and 2 out of 22 infants tested from 3-15 days of life (group B) were found to be HIV-1 positive in both PCR and virus culture. Re-testing at 1 month of age identified additional 8 infected children (6 and 2 in group A and B, respectively). Quantitative PCR analysis in 1-3 month old infected infants showed that HIV-1 proviral copy number ranged from 10 -greater than 750/10(5) PBMC; high number of HIV-1 copies correlated with onset of AIDS within first year of life. CONCLUSIONS. HIV-1 diagnosis cannot be achieved at birth in most infected children, which suggests that mother-to-child transmission occurs late in pregnancy and/or during delivery. Quantitative PCR results in 1-3 month old infants may be useful to identify the early progressors to AIDS.
Keywords: AEGIS, HIV-1, Disease Transmission, Vertical, Polymerase Chain Reaction, HIV Infections, HIV Antibodies, Proviruses, Acquired Immunodeficiency Syndrome, HIV Core Protein p24, HIV Envelope Protein gp120, HIV Antigens, HIV Seropositivity, HIV, Prognosis, Infant, Human, Child, Infant, Newborn, Female, Pregnancy, transmission, ICA8
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