Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
Newsday - May 1, 1990
Laurie Garrett - Staff Writer
In Proceedings of the National Academy of Sciences, to be published today, doctors at New York's Albert Einstein Medical School report that a new medical test found protective antibodies in pregnant women. In a study of 15 pregnant women infected with the human immunodeficiency virus (HIV), Dr. Ayre Rubinstein of the medical school was able to predict accurately, based on the levels of antibodies, which of the mothers would give birth to infected children in every case. Previous tests have been far less reliable.
In New York, women who are HIV-positive give birth to infected children about 32 percent of the time in a first pregnancy and 70 percent of the time in a second pregnancy, Rubinstein said.
The study is also the first confirmed demonstration that human beings are capable of making antibodies that prevent HIV infection, said Dr. Wayne Koff, director of AIDS vaccine research for the National Institute of Allergy and Infectious Diseases.
Koff said the Rubinstein study showed that the HIV-positive mothers who gave birth to healthy babies had high levels of antibodies against a piece of the AIDS virus known as gp120.
"Maternal antibody to gp120 appears to correlate with protection of the infant from acquiring disease," Dr. John Modlin of Johns Hopkins Medical School said. "It's a very exciting finding. If it's true, it raises the possibility that one might intervene by stimulating levels of antibodies to this protein [gp120] in the mothers to prevent transmission to the child."
Several scientific groups, including the Karolinska Institute in Sweden and a team at the National Institutes of Health, previously showed a weak correlation between maternal gp120 antibody levels and HIV infection of children. But Rubinstein's work is based on a medical test that is fundamentally different because it measures the presence of types of HIV viruses most commonly found in American patients. Earlier tests were on the HIV strains found almost exclusively in the laboratory.
The medical test, which was developed by Dr. Yair Devash of Johnson & Johnson, must now be tried in a larger group of pregnant women. "I don't believe it's going to be a 100 percent correlation," Rubinstein said. "But it's going to be the highest ever seen, whether it's 70 percent or 80 percent."
Devash is trying to develop a commercial diagnostic test for fetal infection based on the gp120 finding. "It's a preliminary study. However, if it pans out to be true you will be able to determine in utero whether the fetus is infected and treat the infected fetus with AZT or other drugs," he said.
"We have already made a possible vaccine, which I hope to have produced for use in monkeys within two months."
The vaccine is intended to boost the levels of gp120 antibodies in pregnant women, he said, and scientists should know whether it works within nine months.
"It gives you a rationale for a vaccine for the first time. But the approach we are using may not work. And an approach which works in HIV-positive mothers may not work in the uninfected individual. That's all going to be resolved in the next two to three years," Rubinstein said.
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