WOMEN AND INFANTS TRANSMISSION STUDY (WITS-III)

描述：妇女和婴儿传播研究(WITS)登记 将感染艾滋病毒的孕妇和她们的婴儿合并为多中心， 以回答关键问题为目标的流行病学队列研究 与垂直传播有关，与怀孕期间和 婴儿期。此外，还研究了与实施 对这一人群的治疗干预将得到解决。具体的 WITS的目的是1)确定围产期艾滋病毒的传播机制 以及与传播有关的母体辅助因素，包括 母体用药、胎盘的作用、胎盘的作用和特点 产道中的艾滋病毒和母亲合并感染；2)评估因素 与成功的围产期艾滋病毒预防战略有关，并与 评估发生的传播病例，尽管在围产期使用 抗逆转录病毒药物；3)确定怀孕对疾病进展的影响 妇女在产后感染艾滋病毒的情况，包括 妊娠期间的免疫学和病毒学变化；4)急性艾滋病毒的特征 根据抗逆转录病毒治疗，艾滋病毒感染儿童的感染情况， 预防和免疫基础治疗；5)决定预测因素 年HIV感染儿童队列中的儿科疾病进展 机智。波士顿/伍斯特调查财团寻求继续 参与智慧，利用同样经验丰富的调查人员和 现场工作人员已成功救起300多名孕妇和 到目前为止，有250名艾滋病毒高危婴儿。申请者建议扩大 合作调查员的大量专业知识通过增加基本的 科学顾问以及两个具体的科学合作。他们 建议1)利用新的敏感技术来执行 对儿童HIV感染的CTL反应的详细分析 有助于了解围产期HIV的发病机制和进展 感染以及指导免疫治疗干预的见解；以及 2) 探讨垂直传播与两者相关的发病机制 CC趋化因子受体基因及其受体表达的个体发育研究 传播病毒的特定毒株的嗜性。

DESCRIPTION: The Women and Infants Transmission Study (WITS) enrolls HIV-infected pregnant women and their infants into a multicenter, epidemiologic cohort study whose objectives are to answer critical questions relevant to vertical transmission, and to HIV disease during pregnancy and infancy. In addition, research issues relevant to implementation of therapeutic intervention in this population will be addressed. The specific aims of WITS are to 1) Determine mechanisms of perinatal HIV transmission and maternal cofactors related to transmission including the role of maternal drug use, the role of the placenta, the role and characteristics of HIV in the birth canal, and of maternal coinfections; 2) Evaluate factors related to successful perinatal HIV prevention strategies, and intensely assess transmission cases that occur despite perinatal use of antiretrovirals; 3) Determine the impact of pregnancy on disease progression of HIV infection among women through the postpartum period, including immunologic and virologic changes in pregnancy; 4) Characterize acute HIV infection among HIV-infected children in light of antiretroviral, prophylactic and immune-based therapy; 5) Determine factors predicting pediatric disease progression among the cohort of HIV infected children in WITS. A Boston/Worcester consortium of investigators seeks to continue participation in WITS, utilizing the same experienced investigators and field staff that have successfully accrued over 300 pregnant women and over 250 HIV-at risk infants to date. The applicants propose to expand on the considerable expertise of the co-investigators by the addition of basic science consultants as well as two specific scientific collaborations. They propose 1) The utilization of new and sensitive techniques to perform a detailed analysis of CTL responses to pediatric HIV infection that will be helpful in understanding the pathogenesis and progression of perinatal HIV infection as well as insights to guide immunotherapeutic intervention; and 2) To explore the pathogenesis of vertical transmission in relation to both ontogeny of expression of CC chemokine receptor genes and also to receptor - tropism of particular strains of transmitted virus.