Quantitation of human immunodeficiency virus type 1 during pregnancy: relationship of viral titer to mother-to-child transmission and stability of viral load.
Quantitation of human immunodeficiency virus type 1 during pregnancy: relationship of viral titer to mother-to-child transmission and stability of viral load.
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妊娠期间 1 型人类免疫缺陷病毒的定量：病毒滴度与母婴传播和病毒载量稳定性的关系。
DOI：
10.1073/pnas.91.17.8037
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发表时间：
1994
影响因子：
11.1
通讯作者：
Burger,H
中科院分区：
文献类型：
--
作者：
Weiser,B;Nachman,S;Tropper,P;Viscosi,KH;Grimson,R;Baxter,G;Fang,G;Reyelt,C;Hutcheon,N;Burger,H
为了制定预防1型人类免疫缺陷病毒（HIV-1）母婴传播的战略，必须确定决定这种传播的因素。我们检查了母体HIV-1滴度与母婴传播发生之间的关系。此外，我们对母亲在怀孕期间、分娩时以及产后1年内的HIV-1进行了纵向定量。为了检验传播，我们前瞻性地研究了19对母子；其中5对发生了HIV-1传播。我们使用外周血单个核细胞的终点稀释培养来测定母体病毒滴度，发现尽管病毒滴度为每10(6)个细胞125个HIV-1感染单位的6名妇女中有4名（67%）将HIV-1传染给了她们的婴儿，但病毒滴度较低的13名妇女中只有1名（7.6%）传播（P = 0.01）。19位母亲中有12位在18至65周的时间内连续检测了3-8次HIV-1载量。这12名女性的病毒滴度差异很大，但随着时间的推移，每位女性的病毒载量保持稳定。在这个队列中，HIV-1病毒载量在怀孕期间保持稳定，母体病毒负担越大，越有可能发生传播。这两项相关的发现表明，在怀孕早期测定HIV-1滴度可以预测哪些妇女有将HIV-1传染给婴儿的高风险，并可用于为感染HIV-1的育龄妇女提供咨询。这些数据确定了母体病毒滴度是HIV-1母婴传播的主要决定因素，从而为旨在通过降低病毒载量来阻断传播的治疗策略提供了科学依据。
To develop strategies to prevent mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1), it is important to define the factors determining it. We examined the relationship between maternal HIV-1 titer and the occurrence of mother-to-child transmission. In addition, we quantitated HIV-1 longitudinally in mothers during pregnancy, at delivery, and up to 1 year postpartum. To examine transmission, we prospectively studied 19 mother-child pairs; in 5 pairs, HIV-1 transmission occurred. We used endpoint dilution culture of peripheral blood mononuclear cells to determine maternal viral titer and found that although 4 of 6 (67%) women with viral titers of > or = 125 HIV-1 infectious units per 10(6) cells transmitted HIV-1 to their infants, only 1 of 13 (7.6%) women with lower viral titers transmitted (P = 0.01). Twelve of the 19 mothers had HIV-1 loads determined serially 3-8 times over periods ranging from 18 to 65 weeks. Viral titers varied greatly between the 12 women, but the viral load in each woman remained stable over time. In this cohort, HIV-1 viral load remained stable during pregnancy and the greater the maternal viral burden, the more likely that transmission occurred. These two related findings suggest that determination of HIV-1 titers early in pregnancy may predict which women are at high risk of transmitting to their infants and may be used to counsel HIV-1-infected women of childbearing age. These data identify maternal viral titer as a major determinant of mother-to-child HIV-1 transmission and thereby provide the scientific rationale for therapeutic strategies designed to interrupt transmission by lowering viral load.