AIDS TREATMENT NEWS Issue #209, October 21, 1994
John S. James
This study was directed by Barbara Weiser, M.D., and Harold Burger, M.D., co-directors of HIV research at the New York State Department of Health's Wadsworth Center in Albany, New York, and including investigators at other medical centers in New York and New Jersey. It measured the plasma HIV RNA levels in 27 mothers at the time of delivery. Eight of the 11 mothers with the highest levels of HIV RNA (greater than 175,000 copies per ml of plasma) transmitted HIV to their infants; but none of the 16 mothers with lower viral load transmitted HIV. This result was strongly statistically significant (p<.001).
The researchers had already published a paper in which they used quantitative viral cultures, instead of plasma HIV RNA, to measure viral load in the mothers' blood. The viral cultures worked less well; one mother with a low level and three with a mid-range level (in the viral culture tests) had high levels of HIV RNA, and did transmit the virus.
The researchers concluded, "These data identify HIV-1 plasma RNA level as a major determinant of mother-to-child transmission and provide a strong scientific rationale for implementing multiple strategies to interrupt transmission by reducing viral load."
This work was funded by the Pediatric AIDS Foundation, and the U.S. National Institutes of Health.
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