HIV-1 RNA detection in the amniotic fluid of HIV-infected pregnant women

Lobato, Ana Christina de Lacerda; Aguiar, Regina Amélia Lopes Pessoa de; Aleixo, Agdemir Waléria; Andrade, Beatriz Amélia Monteiro de; Cavallo, Ines Katherina; Kakehasi, Fabiana Maria; Pinto, Jorge; Melo, Victor Hugo

doi:10.1590/s0074-02762010000500021

Cited by 5 publications

(4 citation statements)

References 11 publications

(14 reference statements)

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“…These studies suggest that if HIV is present in amniotic fluid, it is likely rare or present at low levels. Furthermore, even in the study where HIV was reported in amniotic fluid, the presence or level of virus was not correlated with infant infection risk in utero [43]. Studies of virus in amniotic fluid are limited, partially over concerns that such an invasive procedure may increase the transmission risk [46][47][48].…”

Section: Evidence For Cell-associated and Cell-free Virus Transmission During In Utero Transmissionmentioning

confidence: 92%

“…The role of cell-free virus transmission through amniotic fluid in humans, however, is unclear and controversial. While there have been cases where HIV has been detected in amniotic fluid [42,43], others have shown no evidence of HIV in amniotic fluid [44,45]. These studies suggest that if HIV is present in amniotic fluid, it is likely rare or present at low levels.…”

Section: Evidence For Cell-associated and Cell-free Virus Transmission During In Utero Transmissionmentioning

confidence: 95%

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The Role of Cell-Associated Virus in Mother-to-Child HIV Transmission

Milligan

Overbaugh

2014

Journal of Infectious Diseases

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Mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) continues to contribute to the global burden of disease despite great advances in antiretroviral (ARV) treatment and prophylaxis. In this review, we discuss the proposed mechanisms of MTCT, evidence for cell-free and cell-associated transmission in different routes of MTCT, and the impact of ARVs on virus levels and transmission. Many population-based studies support a role for cell-associated virus in transmission and in vitro studies also provide some support for this mode of transmission. However, animal model studies provide proof-of-principle that cell-free virus can establish infection in infants, and studies of ARVs in HIV-infected pregnant women show a strong correlation with reduction in cell-free virus levels and protection. ARV treatment in MTCT potentially provides opportunities to better define the infectious form of virus, but these studies will require better tools to measure the infectious cell reservoir.

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Section: Evidence For Cell-associated and Cell-free Virus Transmission During In Utero Transmissionmentioning

confidence: 92%

Section: Evidence For Cell-associated and Cell-free Virus Transmission During In Utero Transmissionmentioning

confidence: 95%

The Role of Cell-Associated Virus in Mother-to-Child HIV Transmission

Milligan

Overbaugh

2014

Journal of Infectious Diseases

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“…Early studies suggested that in utero transmission may occur though HIV in the amniotic fluid coming into contact with fetal mucosal surfaces ( 12 ). Although the fetal gastrointestinal tract is populated with targets for HIV infection (e.g., CD4+CCR5+ T cells) ( 13 ), more recent studies have found that even in women with detectable virus in the plasma, HIV is not detected in the amniotic fluid ( 14 – 16 ). Another study found that amniotic fluid has innate inhibitory activity against the replication of HIV ( 17 ).…”

Section: Routes and Mechanisms Of Vertical Transmissionmentioning

confidence: 99%

Understanding Viral and Immune Interplay During Vertical Transmission of HIV: Implications for Cure

et al. 2021

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Despite the significant progress that has been made to eliminate vertical HIV infection, more than 150,000 children were infected with HIV in 2019, emphasizing the continued need for sustainable HIV treatment strategies and ideally a cure for children. Mother-to-child-transmission (MTCT) remains the most important route of pediatric HIV acquisition and, in absence of prevention measures, transmission rates range from 15% to 45% via three distinct routes: in utero, intrapartum, and in the postnatal period through breastfeeding. The exact mechanisms and biological basis of these different routes of transmission are not yet fully understood. Some infants escape infection despite significant virus exposure, while others do not, suggesting possible maternal or fetal immune protective factors including the presence of HIV-specific antibodies. Here we summarize the unique aspects of HIV MTCT including the immunopathogenesis of the different routes of transmission, and how transmission in the antenatal or postnatal periods may affect early life immune responses and HIV persistence. A more refined understanding of the complex interaction between viral, maternal, and fetal/infant factors may enhance the pursuit of strategies to achieve an HIV cure for pediatric populations.

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“…Similarly, a study of amniotic fluid from 23 HIV-infected women taken at elective Caesarean section did not show the presence of HIV RNA (20). An examination of 40 HIV-infected women who had amniotic fluid sampled during elective Caesarean section revealed HIV RNA in three samples (7.5%); in each case, VL in the amniotic fluid was <100 copies/mL, the mother was on ART with a suppressed plasma VL and all three neonates had undetectable plasma VL at birth (22). These data suggest that while HIV RNA may infrequently be present in amniotic fluid, this does not necessarily translate to fetal infection.…”

Section: Discussionmentioning

confidence: 91%

Amniocentesis in the HIV-Infected Pregnant Woman: Is There Still Cause for Concern in the Era of Combination Antiretroviral Therapy?

Andany

Letchumanan

Bondy

et al. 2013

Canadian Journal of Infectious Diseases and Medical Microbiolog

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The current standard of care in Canadian obstetrical practice is to offer pregnant women the opportunity for prenatal investigation to diagnose congenital abnormalities. Prenatal amniocentesis is Canada's most commonly practiced invasive procedure for the diagnosis of chromosomal and single gene disorders. The potential risk of intrapartum HIV transmission during amniocentesis raises several ethical concerns and limits the availability of prenatal genetic testing for HIV-positive pregnant women. Complete virological suppression with antiretroviral therapy may alleviate the risk of mother-to-child transmission during amniocentesis and increase accessibility of this important diagnostic tool in the HIV-positive population. The present report describes a case involving a 32-year-old HIV-positive pregnant woman whose plasma viral load was undetectable on antiretroviral therapy; she underwent successful prenatal amniocentesis without transmission of HIV to her infant.

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HIV-1 RNA detection in the amniotic fluid of HIV-infected pregnant women

Cited by 5 publications

References 11 publications

The Role of Cell-Associated Virus in Mother-to-Child HIV Transmission

The Role of Cell-Associated Virus in Mother-to-Child HIV Transmission

Understanding Viral and Immune Interplay During Vertical Transmission of HIV: Implications for Cure

Amniocentesis in the HIV-Infected Pregnant Woman: Is There Still Cause for Concern in the Era of Combination Antiretroviral Therapy?

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