Zidovudine administered to women infected with human immunodeficiency virus type 1 and to their neonates reduces pediatric infection independent of an effect on levels of maternal virus☆,☆☆,★
Section snippets
Subjects
Study subjects were 42 HIV-infected pregnant women who were enrolled between October 1989 and December 1995 in an ongoing study of HIV-1 genetic variability according to a protocol approved by the institutional review board of the University of Florida. Forty-one women were enrolled at the University of Florida in Gainesville and one at the University of South Florida in Tampa. Nineteen women in the study and their neonates received ZDV according to ACTG protocol 076, which was initiated in
Characteristics of study population
Clinical and demographic characteristics of the 42 individual women enrolled in the study are shown in Table I.
Patient No. Age Race Transmission status CDC stage Mode of delivery p24 Ag CD4 + /T cells/μl CD4/CD8 ratio Untreated 564 23 B T A1 VD − 882 1.03 184 23 B T A1 VD − 750 0.67 211 17 B T A1 VD + 396 0.43 567 19 W T A1 VD − 550 0.54 051 27 B T C3 VD + 296 0.28 250 29 B T C3 VD + 39 0.07 1400 31 H T A2 VD + 68 0.07 402 30 B T C3 CD + 7 0.03 559 32 B T C3 CD + 133 0.12 313 26 B T C3 VD + 102 0.12 179 29 B T C3 VD − 38 0.01 566 23 B NT A1 VD − 995 1.33 369
DISCUSSION
In the absence of antiviral therapy for HIV-1 infected mothers and their infants, a significant relationship between maternal immunologic and virologic parameters and the risk of HIV-1 infection for the infant was detected in our study. An increased likelihood of transmission within our cohort of untreated HIV-1 infected women was inversely related to maternal CD4 + T-cell counts and CD4/CD8 ratios and was directly associated with levels of HIV-1 DNA copies found in CD4 + T cells in maternal
Acknowledgements
The 8E5 cell line was received from Dr. Thomas Folks through the National Institute of Allergy and Infectious Diseases AIDS Research and Reference Reagent Program. We are grateful to Drs. Robert Nelson and Patricia Emmanuel for providing maternal samples, to Cynthia Anders for plasma virus determinations, to Mabel Rojas for sample preparation, and to Dr. David Burchfield for his helpful discussion.
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Cited by (27)
Zidovudine monotherapy and the prevention of mother-to-child HIV-1 transmission
2005, Lancet Infectious DiseasesTrends in perinatal HIV transmission and possible related factors
2005, Anales de Pediatria13. HIV-1 infection
2003, Journal of Allergy and Clinical ImmunologyMaternal HIV-1 DNA load and mother-to-child transmission
2007, AIDS Patient Care and STDsPediatric and adolescent HIV/AIDS
2003, Handbook of Pediatric Psychology in School Settings
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0022-3476/97/$5.00 + 0 9/21/79178
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Supported by Public Health Service award HD32259 from the National Institute of Child Health and Human Development (Drs. Goodenow and Sleasman), by Pediatric AIDS Foundation award 50335-14-PG (Dr. Sleasman), by the Children's Miracle Network, and by the Conselho Nacional de Desenvolvimento Cientfaifico e Tecnológico (CNPq) award 202732-91-6 of Brazil (Dr. Aleixo).
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Reprint requests: John W. Sleasman, MD, University of Florida College of Medicine, Box 100296, Room R1-118, 1600 SW Archer Rd., Gainesville, FL 32610.