AEGiS-CATIE: TESTING: Pregnancy and HIV: why some babies escape infection

TESTING: Pregnancy and HIV: why some babies escape infection

TreatmentUpdate57, Vol. 7, No. 3 - March 1995
Sean Hosein

* THEORY VERSUS REALITY

According to the World Health Organization, approximately 1 million children worldwide are infected with HIV. In the USA every year 7,000 HIV-infected women give birth to between 1,000 and 2,000 infected infants. On average between 75% to 85% of babies are born without HIV infection although their mothers are infected. Several research teams are studying infants born to these mothers, but these teams have produced more theories than clear answers. In general, it seems that the state of the mother's immune system and severity of HIV infection may play a role in the outcome of pregnancy. In some studies it appears that breast feeding may transmit the virus. In several studies it appears that fetuses' with strong CMI (cell-mediated immunity) were less likely to be HIV-infected compared to other fetuses with weak CMI. Women with HIV-2 infection seem less likely to transmit that virus to the fetus.

REFERENCES:

1. Glausiuz J. HIV: The babies who escape. New Scientist 16 April, 1994, pages 38 to 42.

2. Khouri YF, McIntosh K, Cavacini L, et al. Vertical transmission of HIV-1: correlation with maternal viral load and plasma levels of CD4 binding site anti-gp120 antibodies. Journal of Clinical Investigation 1995;95:732-737.

3. Clerici M, Sison A, Berzofsky JA, et al. Cellular immune factors associated with mother-to-infant transmission of HIV. AIDS 1993;7:1427-1433.

4. Kilk SC, Wara DW, Landers DV and Levy JA. Features of HIV-1 that could influence maternal-child transmission. Journal of the American Medical Association 1994;272(6):467-474.

5. Douglas SD. Immunological and virological clues for mother-to-child transmission of HIV-1 and HIV-2. Journal of the American Medical Association 1994;272(6):487-488.

6. Rowlands-Jones SL, Nixon DF, Alderhous MC, et al. HIV-specific cytotoxic T-cell activity in an HIV-exposed but uninfected infant. Lancet 1993;341:860-861.

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