Maternal plasma human immunodeficiency virus type 1 RNA level: a determinant and projected threshold for mother-to-child transmission.
Maternal plasma human immunodeficiency virus type 1 RNA level: a determinant and projected threshold for mother-to-child transmission.
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母体血浆人类免疫缺陷病毒 1 型 RNA 水平：母婴传播的决定因素和预计阈值。
DOI：
10.1073/pnas.92.26.12100
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发表时间：
1995
影响因子：
11.1
通讯作者：
Weiser,B
中科院分区：
文献类型：
--
作者：
Fang,G;Burger,H;Grimson,R;Tropper,P;Nachman,S;Mayers,D;Weislow,O;Moore,R;Reyelt,C;Hutcheon,N;Baker,D;Weiser,B
为了防止母婴传播人类免疫缺陷病毒1型（HIV-1），确定其决定因素非常重要。由于HIV-1 RNA水平可以通过抗病毒治疗降低，我们研究了母体血浆HIV-1 RNA水平在母婴传播中的作用。采用定量竞争PCR法对30例感染孕妇的HIV-RNA进行检测，并对其婴儿进行前瞻性随访；27%的妇女将HIV-1传染给她们的婴儿，母亲血浆HIV-1 RNA水平与传染显著相关。分娩时HIV-1 RNA水平最高的10名妇女中有8名（190,400-1,664,100拷贝/ ml血浆）传播，而20名水平较低的妇女（500-155,800拷贝/ ml）中没有一人传播（P = 0.0002）。对这30名妇女中HIV-1 RNA载量分布的统计分析预测了在更大人群中母婴传播的阈值；病毒RNA水平<或= 100,000拷贝/ ml的女性不传播的概率预计为97%。妊娠期HIV-1 RNA序列水平检测显示，未开始或改变抗病毒治疗的妇女的病毒载量是稳定的。这些数据确定母体血浆HIV-1 RNA水平是母婴传播的主要决定因素，并提示HIV-1 RNA的定量可以预测传播风险。
To prevent mother-to-child human immunodeficiency virus type 1 (HIV-1) transmission, it is important to identify its determinants. Because HIV-1 RNA levels can be reduced by antiviral therapy, we examined the role of maternal plasma HIV-1 RNA level in mother-to-child transmission. We used quantitative competitive PCR to measure HIV-RNA in 30 infected pregnant women and then followed their infants prospectively; 27% of the women transmitted HIV-1 to their infants and maternal plasma HIV-1 RNA level correlated strikingly with transmission. Eight of the 10 women with the highest HIV-1 RNA levels at delivery (190,400-1,664,100 copies per ml of plasma) transmitted, while none of the 20 women with lower levels (500-155,800 copies per ml) did (P = 0.0002). Statistical analysis of the distribution of HIV-1 RNA loads in these 30 women projected a threshold for mother-to-child transmission in a larger population; the probability of a woman with a viral RNA level of < or = 100,000 copies per ml not transmitting is predicted to be 97%. Examination of serial HIV-1 RNA levels during pregnancy showed that viral load was stable in women who did not initiate or change antiviral therapy. These data identify maternal plasma HIV-1-RNA level as a major determinant of mother-to-child transmission and suggest that quantitation of HIV-1 RNA may predict the risk of transmission.