Rate of Transmission of Human Immunodeficiency Virus Type 1 Infection From Mother to Child and Short-term Outcome of Neonatal Infection

Andiman, Warren A.; Simpson, B. Joyce; Olson, Betty; Dember, Laura M.; Silva, Thomas J.; Miller, George

doi:10.1001/archpedi.1990.02150310026020

Cited by 85 publications

(26 citation statements)

References 21 publications

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“…Significantly, the amino acid signature pattern identified in the maternal sequences was present in most sequences from all members of each family (Tables IV and V, shaded residues). The amino acid signature positions in the V 1 domain were designated 1 through 7 and those in V2, 8 through 12. Positions in C2, designated 13 …”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Persistence of multiple maternal genotypes of human immunodeficiency virus type I in infants infected by vertical transmission.

Lamers¹,

Sleasman²,

She³

et al. 1994

J. Clin. Invest.

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The extent of nucleotide variation within the HIV-1 env hypervariable domains serves as a marker of virus genotypes within infected individuals and as a means to track transmission of the virus between individuals. We analyzed env VI and V2 sequences in longitudinal samples from two HIV-1-infected mothers, each with three children infected by maternal transmission of the virus. Sequences in samples that were obtained from two infants at 2 d and 4 wk after birth displayed more variation in V1 and V2 than maternal samples obtained at the same times. Multiple HIV-1 genotypes were identified in each mother. In each family, multiple maternal HIV-1 genotypes were transmitted to the infants. Specific amino acid residues in the hypervariable domains were conserved within sequences from each family producing a family-specific amino acid signature pattern in V1 and V2. Viruses that were highly related to maternal viruses in signature pattern persisted for as long as 4 yr in the older children. Results support a model of transmission involving multiple HIV-1 genotypes with development of genetic variation from differential outgrowth and accumulation of genetic changes within each individual. (J. Clin. Invest. 1994. 93:380-390.) Key words: human immunodeficiency virus 1 genetic variation * maternal transmission

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Section: Methodsmentioning

confidence: 99%

“…Maternal transmission ofhuman immunodeficiency virus type I (HIV-1) occurs in -15 to 35% of infants born to infected women ( [1][2][3][4][5][6][7][8][9][10] ). Why more than two thirds of the infants born to HIV-1-infected women apparently escape infection by the virus raises important questions about virus-host interactions.…”

Section: Introductionmentioning

confidence: 99%

Persistence of multiple maternal genotypes of human immunodeficiency virus type I in infants infected by vertical transmission.

Lamers¹,

Sleasman²,

She³

et al. 1994

J. Clin. Invest.

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“…95 Studies of the decay of maternally derived antibodies to HIV-1 indicate that most children serorevert (ie, lose maternal antibodies) by 12 months of age. [96][97][98][99] However, the median time to loss of maternal antibody has varied in different studies, with numbers of subjects ranging from 40 to 520 (eg, 7 months, 100 11.6 months, 101 and 13.3 months 102 ), and a small proportion of uninfected children remained HIV-1 antibody-positive at 15 months 98 or 18 months. 96 Therefore, loss of maternal antibody (seroreversion) as an HIV-1-exposed child …”

Section: Age Of the Childmentioning

confidence: 99%

Diagnosis of HIV-1 Infection in Children Younger Than 18 Months in the United States

Read¹

2007

Pediatrics

118

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The objectives of this technical report are to describe methods of diagnosis of HIV-1 infection in children younger than 18 months in the United States and to review important issues that must be considered by clinicians who care for infants and young children born to HIV-1–infected women. Appropriate HIV-1 diagnostic testing for infants and children younger than 18 months differs from that for older children, adolescents, and adults because of passively transferred maternal HIV-1 antibodies, which may be detectable in the child's bloodstream until 18 months of age. Therefore, routine serologic testing of these infants and young children is generally only informative before the age of 18 months if the test result is negative. Virologic assays, including HIV-1 DNA or RNA assays, represent the gold standard for diagnostic testing of infants and children younger than 18 months. With such testing, the diagnosis of HIV-1 infection (as well as the presumptive exclusion of HIV-1 infection) can be established within the first several weeks of life among nonbreastfed infants. Important factors that must be considered when selecting HIV-1 diagnostic assays for pediatric patients and when choosing the timing of such assays include the age of the child, potential timing of infection of the child, whether the infection status of the child's mother is known or unknown, the antiretroviral exposure history of the mother and of the child, and characteristics of the virus. If the mother's HIV-1 serostatus is unknown, rapid HIV-1 antibody testing of the newborn infant to identify HIV-1 exposure is essential so that antiretroviral prophylaxis can be initiated within the first 12 hours of life if test results are positive. For HIV-1–exposed infants (identified by positive maternal test results or positive antibody results for the infant shortly after birth), it has been recommended that diagnostic testing with HIV-1 DNA or RNA assays be performed within the first 14 days of life, at 1 to 2 months of age, and at 3 to 6 months of age. If any of these test results are positive, repeat testing is recommended to confirm the diagnosis of HIV-1 infection. A diagnosis of HIV-1 infection can be made on the basis of 2 positive HIV-1 DNA or RNA assay results. In nonbreastfeeding children younger than 18 months with no positive HIV-1 virologic test results, presumptive exclusion of HIV-1 infection can be based on 2 negative virologic test results (1 obtained at ≥2 weeks and 1 obtained at ≥4 weeks of age); 1 negative virologic test result obtained at ≥8 weeks of age; or 1 negative HIV-1 antibody test result obtained at ≥6 months of age. Alternatively, presumptive exclusion of HIV-1 infection can be based on 1 positive HIV-1 virologic test with at least 2 subsequent negative virologic test results (at least 1 of which is performed at ≥8 weeks of age) or negative HIV-1 antibody test results (at least 1 of which is performed at ≥6 months of age). Definitive exclusion of HIV-1 infection is based on 2 negative virologic test results, 1 obtained at ≥1 month of age and 1 obtained at ≥4 months of age, or 2 negative HIV-1 antibody test results from separate specimens obtained at ≥6 months of age. For both presumptive and definitive exclusion of infection, the child should have no other laboratory (eg, no positive virologic test results) or clinical (eg, no AIDS-defining conditions) evidence of HIV-1 infection. Many clinicians confirm the absence of HIV-1 infection with a negative HIV-1 antibody assay result at 12 to 18 months of age. For breastfeeding infants, a similar testing algorithm can be followed, with timing of testing starting from the date of complete cessation of breastfeeding instead of the date of birth.

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“…Most prior estimates and hypothesis seem to agree that transmission usually occur during the intrapartum HIV exposure just as premature infants. Perinatal or Antepartum HIV transmission has been documented as a route of infection estimated to occur in 13-30% of infants delivered to HIV-1 infected mothers (Andiman et al, 1990). High proviral DNA/ or RNA concentration of virus is a risk factor for the transmission of HIV-1 from an untreated mother to infant.…”

Section: Vertical or Mother To Child Tranmission (Mtct)mentioning

confidence: 99%

Human Immunodeficiency Virus Transmission

Nanjul¹

2011

Global View of HIV Infection

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Rate of Transmission of Human Immunodeficiency Virus Type 1 Infection From Mother to Child and Short-term Outcome of Neonatal Infection

Cited by 85 publications

References 21 publications

Persistence of multiple maternal genotypes of human immunodeficiency virus type I in infants infected by vertical transmission.

Persistence of multiple maternal genotypes of human immunodeficiency virus type I in infants infected by vertical transmission.

Diagnosis of HIV-1 Infection in Children Younger Than 18 Months in the United States

Human Immunodeficiency Virus Transmission

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