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Taramasso L, Bozzano F, Casabianca A, Orlandi C, Bovis F, Mora S, Giacomini M, Moretta L, Magnani M, Di Biagio A, De Maria A. Persistence of Unintegrated HIV DNA Associates With Ongoing NK Cell Activation and CD34+DNAM-1brightCXCR4+ Precursor Turnover in Vertically Infected Patients Despite Successful Antiretroviral Treatment. Front Immunol 2022; 13:847816. [PMID: 35558085 PMCID: PMC9088003 DOI: 10.3389/fimmu.2022.847816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
The quantification of proviral DNA is raising interest in view of clinical management and functional HIV eradication. Measures of all unintegrated HIV DNA (uDNA) forms in infected reservoir cells provides information on recent replication events that is not found from other proviral DNA assays. To evaluate its actual relevance in a cohort of perinatally-infected adult HIV patients (PHIV), we studied how peripheral blood mononuclear cell uDNA levels correlated with total HIV DNA (tDNA) and with overall replication or innate immune control parameters including NK cell activation/exhaustion and lymphoid turnover. Twenty-two PHIV were included, with successfully controlled HIV (HIV RNA <50 copies/mL) on combined antiretroviral therapy for mean of 8.7 ± 3.9 years. uDNA accounted for 16 [5.2-83.5] copies/µg and was strongly correlated with tDNA (ρ=0.700, p=0.001). Flow cytometric analysis of peripheral NK cells showed that CD69 expression was directly correlated uDNA (p=0.0412), but not with tDNA. Interestingly, CD56-CD16+NK cells which include newly described inflammatory precursors and terminally differentiated cells were directly correlated with uDNA levels (p<0.001), but not with tDNA, and an inverse association was observed between the proportion of NKG2D+ NK cells and uDNA (ρ=-0.548, p=0.015). In addition, CD34+DNAM-1brightCXCR4+ inflammatory precursor frequency correlated directly with uDNA levels (ρ=0.579, p=0.0075). The frequencies of CD56-CD16+ and CD34+DNAM-1brightCXCR4+ cells maintained association with uDNA levels in a multivariable analysis (p=0.045 and p=0.168, respectively). Thus, control of HIV-1 reservoir in aviremic patients on ART is an active process associated with continuous NK cell intervention and turnover, even after many years of treatment. Quantification of linear and circular uDNA provides relevant information on the requirement for ongoing innate immune control in addition to ART, on recent replication history and may help stratify patients for functional HIV eradication protocols with targeted options.
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Affiliation(s)
- Lucia Taramasso
- Infectious Diseases Clinic, IRCCS Policlinico San Martino Hospital, Genoa, Italy
| | - Federica Bozzano
- Infectious Diseases Clinic, IRCCS Policlinico San Martino Hospital, Genoa, Italy
| | - Anna Casabianca
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Chiara Orlandi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Francesca Bovis
- Biostatistics Unit, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Sara Mora
- Department of Informatics, Bioengineering, Robotics and System Engineering (DIBRIS), University of Genoa, Genoa, Italy
| | - Mauro Giacomini
- Department of Informatics, Bioengineering, Robotics and System Engineering (DIBRIS), University of Genoa, Genoa, Italy
| | - Lorenzo Moretta
- Immunology Research Area, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Mauro Magnani
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Antonio Di Biagio
- Infectious Diseases Clinic, IRCCS Policlinico San Martino Hospital, Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Andrea De Maria
- Infectious Diseases Clinic, IRCCS Policlinico San Martino Hospital, Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
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Tamalet C, Colson P, Decroly E, Dhiver C, Ravaux I, Stein A, Raoult D. Reevaluation of possible outcomes of infections with human immunodeficiency virus. Clin Microbiol Infect 2016; 22:299-311. [PMID: 26794031 DOI: 10.1016/j.cmi.2015.11.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 11/15/2015] [Accepted: 11/21/2015] [Indexed: 02/05/2023]
Abstract
Several lines of evidence indicate that HIV infection can result in several possible incomes, including a very small proportion of individuals whose HIV replication is controlled after treatment interruption (known as HIV posttreatment controllers) or spontaneously without any treatment (known as HIV elite controllers). Both types of individuals are HIV RNA negative but HIV DNA positive, with living virus which can be stimulated ex vivo. A review was conducted to assess the literature on yet rarer cases with detectable integrated HIV DNA without HIV infectious virus in HIV-seropositive or -negative individuals. Three categories of patients were identified: (a) HIV-seropositive individuals with apparent spontaneous cure from their HIV infection, (b) HIV-seronegative children born to HIV-infected mothers and (c) highly exposed seronegative adults. Validity criteria were proposed to assess the presence of integrated HIV DNA as possible or unquestionable in these three categories. Only three articles among the 22 ultimately selected fulfilled these criteria. Among the highly exposed seronegative subjects, some individuals were described as being without integrated HIV DNA, probably because these subjects were not investigated using relevant, highly sensitive methods. Finally, we propose a definition of spontaneous cure of HIV infection based on clinical, immunologic and virologic criteria.
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Affiliation(s)
- C Tamalet
- IHU Méditerranée Infection, Assistance Publique-Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, France; Aix-Marseille University, URMITE UM 63 CNRS 7278 IRD 198 INSERM U1095, France
| | - P Colson
- IHU Méditerranée Infection, Assistance Publique-Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, France; Aix-Marseille University, URMITE UM 63 CNRS 7278 IRD 198 INSERM U1095, France
| | - E Decroly
- Aix-Marseille University, CNRS AFMB Laboratory, UMR 7257, Case 925, France
| | - C Dhiver
- IHU Méditerranée Infection, Assistance Publique-Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, France; Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Service des Maladies Infectieuses, Hôpital Conception, Marseille, France
| | - I Ravaux
- IHU Méditerranée Infection, Assistance Publique-Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, France; Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Service des Maladies Infectieuses, Hôpital Conception, Marseille, France
| | - A Stein
- IHU Méditerranée Infection, Assistance Publique-Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, France; Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Service des Maladies Infectieuses, Hôpital Conception, Marseille, France
| | - D Raoult
- IHU Méditerranée Infection, Assistance Publique-Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, France; Aix-Marseille University, URMITE UM 63 CNRS 7278 IRD 198 INSERM U1095, France.
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Gianesin K, Petrara R, Freguja R, Zanchetta M, Giaquinto C, De Rossi A. Host factors and early treatments to restrict paediatric HIV infection and early disease progression. J Virus Erad 2015. [DOI: 10.1016/s2055-6640(20)30509-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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Tobin NH, Aldrovandi GM. Are infants unique in their ability to be "functionally cured" of HIV-1? Curr HIV/AIDS Rep 2014; 11:1-10. [PMID: 24390641 DOI: 10.1007/s11904-013-0189-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The recent report of an infant that appears to have achieved a "functional cure" of HIV-1 following receipt of antiretroviral therapy (ART) within 30 hours of birth raises many questions: was the child infected? Was this result due to unique features of this particular infant's immune system, the immune system of infants or the very early initiation of effective ART? In this manuscript, we discuss the pathogenesis of HIV-1 in infants, highlighting the unique features of infant immune development and how these may inform efforts to cure HIV infection. We will also compare the path to infant "cure" to cures in adults.
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Affiliation(s)
- Nicole H Tobin
- Department of Pediatrics, Children's Hospital Los Angeles, 4650 Sunset Blvd., MS#51, Los Angeles, CA, 90027, USA
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Johnson EL, Howard CL, Thurman J, Pontiff K, Johnson ES, Chakraborty R. Cytomegalovirus upregulates expression of CCR5 in central memory cord blood mononuclear cells, which may facilitate in utero HIV type 1 transmission. J Infect Dis 2014; 211:187-96. [PMID: 25081935 DOI: 10.1093/infdis/jiu424] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Administration of combination antiretroviral therapy to human immunodeficiency virus type 1 (HIV-1)-infected pregnant women significantly reduces vertical transmission. In contrast, maternal co-opportunistic infection with primary or reactivated cytomegalovirus (CMV) or other pathogens may facilitate in utero transmission of HIV-1 by activation of cord blood mononuclear cells (CBMCs). Here we examine the targets and mechanisms that affect fetal susceptibility to HIV-1 in utero. Using flow cytometry, we demonstrate that the fraction of CD4(+)CD45RO(+) and CD4(+)CCR5(+) CBMCs is minimal, which may account for the low level of in utero HIV-1 transmission. Unstimulated CD4(+) CBMCs that lack CCR5/CD45RO showed reduced levels of HIV-1 infection. However, upon in vitro stimulation with CMV, CBMCs undergo increased proliferation to upregulate the fraction of T central memory cells and expression of CCR5, which enhances susceptibility to HIV-1 infection in vitro. These data suggest that activation induced by CMV in vivo may alter CCR5 expression in CD4(+) T central memory cells to promote in utero transmission of HIV-1.
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Affiliation(s)
- Erica L Johnson
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Chanie L Howard
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Joy Thurman
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Kyle Pontiff
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Elan S Johnson
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Rana Chakraborty
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
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Persaud D, Gay H, Ziemniak C, Chen YH, Piatak M, Chun TW, Strain M, Richman D, Luzuriaga K. Absence of detectable HIV-1 viremia after treatment cessation in an infant. N Engl J Med 2013; 369:1828-35. [PMID: 24152233 PMCID: PMC3954754 DOI: 10.1056/nejmoa1302976] [Citation(s) in RCA: 441] [Impact Index Per Article: 40.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
An infant born to a woman with human immunodeficiency virus type 1 (HIV-1) infection began receiving antiretroviral therapy (ART) 30 hours after birth owing to high-risk exposure. ART was continued when detection of HIV-1 DNA and RNA on repeat testing met the standard diagnostic criteria for infection. After therapy was discontinued (when the child was 18 months of age), levels of plasma HIV-1 RNA, proviral DNA in peripheral-blood mononuclear cells, and HIV-1 antibodies, as assessed by means of clinical assays, remained undetectable in the child through 30 months of age. This case suggests that very early ART in infants may alter the establishment and long-term persistence of HIV-1 infection.
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Affiliation(s)
- Deborah Persaud
- From the Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore (D.P., C.Z., Y.H.C.), Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Frederick (M.P.), and the Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (T.-W.C.) - all in Maryland; the Department of Pediatrics, University of Mississippi Medical Center, Jackson (H.G.); the University of California San Diego, La Jolla, and the Veterans Affairs San Diego Healthcare System, San Diego (M.S., D.R.); and the Department of Pediatrics, Program in Molecular Medicine, and Center for Clinical and Translational Science, University of Massachusetts Medical School, Worcester (K.L.)
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Involvement of activating NK cell receptors and their modulation in pathogen immunity. J Biomed Biotechnol 2011; 2011:152430. [PMID: 21860586 PMCID: PMC3155793 DOI: 10.1155/2011/152430] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Accepted: 05/23/2011] [Indexed: 01/20/2023] Open
Abstract
Natural Killer (NK) cells are endowed with cell-structure-sensing receptors providing inhibitory protection from self-destruction (inhibitory NK receptors, iNKRs, including killer inhibitory receptors and other molecules) and rapid triggering potential leading to functional cell activation by Toll-like receptors (TLRs), cytokine receptors, and activating NK cell receptors including natural cytotoxicity receptors (NCRs, i.e., NKp46, NKp46, and NKp44). NCR and NKG2D recognize ligands on infected cells which may be endogenous or may directly bind to some structures derived from invading pathogens. In this paper, we address the known direct or indirect interactions between activating receptors and pathogens and their expression during chronic HIV and HCV infections.
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Wild J, Bieler K, Köstler J, Frachette MJ, Jeffs S, Vieira S, Esteban M, Liljeström P, Pantaleo G, Wolf H, Wagner R. Preclinical evaluation of the immunogenicity of C-type HIV-1-based DNA and NYVAC vaccines in the Balb/C mouse model. Viral Immunol 2009; 22:309-19. [PMID: 19811088 DOI: 10.1089/vim.2009.0038] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
As part of a European initiative (EuroVacc), we report the design, construction, and immunogenicity of two HIV-1 vaccine candidates based on a clade C virus strain (CN54) representing the current major epidemic in Asia and parts of Africa. Open reading frames encoding an artificial 160-kDa GagPolNef (GPN) polyprotein and the external glycoprotein gp120 were fully RNA and codon optimized. A DNA vaccine (DNA-GPN and DNA-gp120, referred to as DNA-C), and a replication-deficient vaccinia virus encoding both reading frames (NYVAC-C), were assessed regarding immunogenicity in Balb/C mice. The intramuscular administration of both plasmid DNA constructs, followed by two booster DNA immunizations, induced substantial T-cell responses against both antigens as well as Env-specific antibodies. Whereas low doses of NYVAC-C failed to induce specific CTL or antibodies, high doses generated cellular as well as humoral immune responses, but these did not reach the levels seen following DNA vaccination. The most potent immune responses were detectable using prime:boost protocols, regardless of whether DNA-C or NYVAC-C was used as the priming or boosting agent. These preclinical findings revealed the immunogenic response triggered by DNA-C and its enhancement by combining it with NYVAC-C, thus complementing the macaque preclinical and human phase I clinical studies of EuroVacc.
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Affiliation(s)
- Jens Wild
- Institute of Medical Microbiology, University of Regensburg, Regensburg, Germany
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10
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Patel JA, Anderson E, Dong J. False Positive Ultrasensitive HIV bDNA Viral Load Results in Diagnosis of Perinatal HIV-Infection in the Era of Low Transmission. Lab Med 2009. [DOI: 10.1309/lmaotfwvlh1b5a5k] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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11
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Early infant human immunodeficiency virus type 1 detection suitable for resource-limited settings with multiple circulating subtypes by use of nested three-monoplex DNA PCR and dried blood spots. J Clin Microbiol 2007; 46:721-6. [PMID: 18077639 DOI: 10.1128/jcm.01539-07] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The early detection of human immunodeficiency virus type 1 (HIV-1) infection in infants is complicated by the persistence of maternal antibodies and by diverse HIV-1 subtypes. We developed a nested, three-monoplex HIV-1 DNA PCR (N3M-PCR) assay to detect diverse HIV-1 subtypes in infants born to infected mothers. We optimized the test for use with dried blood spot (DBS) samples for ease of storage and transport from rural China to central laboratories. Six pairs of primers were designed that targeted env, gag, and pol genes, and the test was run in three reactions with an analytical sensitivity of 10 copies DNA per reaction to cover nine HIV-1 subtypes, A, B, C, D, F, G, CRF01-AE, CRF08-BC, and CRF07-BC. The assay performance was evaluated on 347 DBS specimens from 151 exposed infants in four diverse provinces of China in which multiple subtypes were circulating. The results of this test were compared to those of HIV antibody enzyme immunoassay and Western blotting confirmation for the infants at > or =18 months of age or to convincing clinical and epidemiologic data for deceased infants. The sensitivity of the N3M-PCR assay was 30.0% (3/10) for infants at 48 h after birth, 91.7% (11/12) at 1 to 2 months of age, and 93.7% (15/16) at 3 to 6 months of age. The specificity was 100% (94/94) at all three time points. The PCR reproducibility in the three DNA regions was 100% for samples at 48 h after birth, 96.7% at 1 to 2 months, and 100% at 3 to 6 months of age. The HIV-1 DNA N3M-PCR assay on DBSs offers a simple and affordable approach for early infant HIV-1 diagnosis in regions with diverse HIV-1 circulating subtypes.
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13
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Pérez JA V, Sigales MC B, G RT, Rosales JC G, Claudín C S. Human Immunodeficiency Virus type 1 in seronegative infants born to HIV-1-infected mothers. Virol J 2006; 3:52. [PMID: 16808849 PMCID: PMC1524729 DOI: 10.1186/1743-422x-3-52] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2006] [Accepted: 06/29/2006] [Indexed: 01/20/2023] Open
Abstract
Background Some individuals repeatedly exposed to Human Immunodeficiency Virus do not seroconvert and are resistant to HIV infection. Here, in a pediatric cohort of HIV seronegative infants born of HIV-infected mothers, we have studied eight non-breastfed children in whom viral DNA was detected in their PBMC. Our objective was to assess whether silent infection in these children can be explained by the presence of integrated viral DNA. Methods The presence of viral DNA was corroborated by nested PCR with primers for gag and the nef/LTR regions of HIV-1. Integration of HIV DNA into the host genome was assessed by an Alu-LTR PCR. Amplicons were sequenced and phylogenetic analyzes were done. Results HIV-1 DNA was detected in the earliest available PBMC sample from all eight infants, and two of them tested positive for HIV DNA at 2 years of age. Nested PCR resulted in the amplification of gag, nef/LTR and Alu-LTR fragments, which demostrated that HIV-1 DNA was integrated in the host cell genome. Each individual has a characteristic sequence pattern and is different from the LTR sequence of HXB2 prototype virus and other Mexican isolates. Conclusion HIV-1 DNA was observed in PBMC from HIV exposed seronegative children in this pediatric cohort.
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Affiliation(s)
- Vázquez Pérez JA
- Unidad de Servicios Para Diagnóstico y Referencia en VIH, Instituto de Investigaciones Biomédicas UNAM/Secretaría de Salud del DF, México D.F
- Centro de Investigaciones en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias, México, D.F. Calzada de Tlalpan 4502 Mexico D.F
- Benjamin Hill 24 Col Condesa, Miguel Hidalgo 06100 México D.F
| | - Basualdo Sigales MC
- Unidad de Servicios Para Diagnóstico y Referencia en VIH, Instituto de Investigaciones Biomédicas UNAM/Secretaría de Salud del DF, México D.F
- Benjamin Hill 24 Col Condesa, Miguel Hidalgo 06100 México D.F
| | - Reyes-Terán G
- Centro de Investigaciones en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias, México, D.F. Calzada de Tlalpan 4502 Mexico D.F
| | - Gudiño Rosales JC
- Instituto de Diagnóstico y Referencia Epidemiológicos, Secretaría de Salud, México D.F. Carpio 470 Sto Tomás México D.F
| | - Soler Claudín C
- Unidad de Servicios Para Diagnóstico y Referencia en VIH, Instituto de Investigaciones Biomédicas UNAM/Secretaría de Salud del DF, México D.F
- Benjamin Hill 24 Col Condesa, Miguel Hidalgo 06100 México D.F
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Abstract
In countries with adequate resources, rates of perinatal mother-to-child-transmission (MTCT) of HIV can be as low as 2% or lower. To achieve this low rate of MTCT of HIV requires identification of women with HIV infection early in pregnancy, treatment of the pregnant woman with appropriate combination antiretroviral therapy, special interventions in maternal management during labor and delivery, and appropriate care of the newborn infant. Although many of the steps in preventing HIV MTCT fall to obstetrical care providers, practitioners focused on care of the newborn also play an important role in the prevention of perinatal HIV MTCT, follow-up to identify or exclude HIV infection in the infant, and ongoing care for children and families affected by HIV.
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Affiliation(s)
- Peter L Havens
- Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA.
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15
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Allison RW, Hoover EA. Covert vertical transmission of feline immunodeficiency virus. AIDS Res Hum Retroviruses 2003; 19:421-34. [PMID: 12804000 DOI: 10.1089/088922203765551764] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Covert vertical transmission of feline immunodeficiency virus (FIV), the feline counterpart of human immunodeficiency virus type 1 (HIV-1), was identified in kittens born to FIV-infected cats. DNA PCR detected FIV gag and env sequences in tissues from kittens nonviable at birth, and in viable kittens monitored postnatally and necropsied at either 11 weeks or 1 year of age. Although FIV DNA was detected in initial blood samples from all 16 viable kittens, viral DNA became increasingly difficult to detect over time and infectious virus could rarely be demonstrated. Only maternal FIV antibody was detected in kitten plasma during the entire postnatal observation period, and kittens remained healthy, with normal CD4:CD8 T cell ratios at >14 months of age. Thus, mother-to-offspring FIV exposure, occurring in utero and postnatally, can result in covert infection in kittens with virus sequestered and contained in tissue sites. These findings appear directly relevant to suspected transient HIV infections and reports of HIV-specific cellular immune responses in highly exposed seronegative adults and uninfected infants born to HIV-positive women.
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Affiliation(s)
- Robin W Allison
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado 80523, USA
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16
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Abstract
The recent spread of HIV infection into the heterosexual population in the United States, Europe, and Australia, as well as its earlier heterosexual presence in the developing world, has led to increased scientific and clinical attention to the role of HIV infection in pregnancy. In managing a pregnant HIV-positive woman, it is most important to treat the patient as someone who is HIV-positive rather than someone who is pregnant. Withholding antiviral or prophylactic therapies from the mother for fear of harming the child is not justified, because failure to treat the mother increases the fetal risk. The most important parameter to follow is the maternal plasma HIV-RNA level, and the most important treatment issue is to reduce this level because it is directly related to the risk of vertical transmission.
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Affiliation(s)
- Donald P Kotler
- Gastrointestinal Division, Department of Medicine, 1301 St. Luke's-Roosevelt Hospital Center, College of Physicians and Surgeons, Columbia University, 1111 Amsterdam Avenue, New York, NY 10025, USA.
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17
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Pembrey L, Newell ML, Tovo PA, van Drimmelen H, Quinti I, Furlini G, Galli S, Meliconi MG, Burns S, Hallam N, Sönnerborg A, Cilla G, Serrano E, Laccetti P, Portella G, Polywka S, Icardi G, Bruzzone B, Balbo L, Alfarano A. Inter-laboratory comparison of HCV-RNA assay results: implications for multi-centre research. J Med Virol 2003; 69:195-201. [PMID: 12683407 DOI: 10.1002/jmv.10283] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
To investigate whether it is appropriate to assume comparability of hepatitis virus C (HCV)-RNA results across laboratories in multi-centre studies, nine laboratories of the European Paediatric HCV Network participated in an international proficiency study of HCV-RNA assays. A panel of 12 samples of different dilutions and genotypes was sent to each laboratory and tested with qualitative and/or quantitative HCV-RNA assays according to local procedures. Commercial assays were used in seven laboratories and in-house assays in two. All six laboratories in which a commercial qualitative assay was used were proficient, as were four of six runs (in five laboratories) in which a commercial quantitative assay was used. The proficiency of the laboratories where in-house assays were used could not be assessed according to the VQC definition because of differences in the methods used. Overall, there were several false-negative results, but only one false-positive result with a quantitative assay and none with a qualitative assay. The false-negative results may have implications for the diagnosis of infection, and highlight the need for an antibody test to be performed at 18 months to confirm the absence of infection. The results of qualitative assays were generally consistent across laboratories but it was difficult to evaluate and compare the results of quantitative assays. Multivariate analysis of data collected in multi-centre studies should therefore allow for centre and/or assay used.
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Affiliation(s)
- Lucy Pembrey
- Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, London, United Kingdom
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Kuhn L, Meddows-Taylor S, Gray G, Tiemessen C. Human immunodeficiency virus (HIV)-specific cellular immune responses in newborns exposed to HIV in utero. Clin Infect Dis 2002; 34:267-76. [PMID: 11740717 DOI: 10.1086/338153] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2001] [Revised: 08/15/2001] [Indexed: 11/03/2022] Open
Abstract
Significant immunological changes are associated with intrauterine human immunodeficiency virus (HIV) encounter among uninfected infants of HIV-infected mothers. Peripheral blood cells of more than one-third of these exposed-uninfected infants proliferate and produce IL-2 after stimulation with HIV, and HIV-specific CD4+ T helper cell responses can be quantified in nearly all when sensitive intracellular cytokine assays are used. HIV-specific CD8+ cytotoxic T lymphocyte responses can be elicited in some, although less frequently. It is difficult to demonstrate that these responses are components of protective immunity and not simply epiphenomena of exposure. However, HIV-specific responses are associated with lack of infection, even with prolonged reexposure through breast-feeding. Elevations in nonspecific markers of immune activation provide further corroboration, as do similar findings in adults, consistent across all known routes of HIV transmission. Many questions remain, but much can be learned from this special population that may be informative for development of effective immunity in response to HIV vaccines.
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Affiliation(s)
- Louise Kuhn
- Gertrude H. Sergievsky Center, College of Physicians and Surgeons, and Division of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
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19
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Ceci O, Margiotta M, Marello F, Francavilla R, Loizzi P, Francavilla A, Mautone A, Impedovo L, Ierardi E, Mastroianni M, Bettocchi S, Selvaggi L. Vertical transmission of hepatitis C virus in a cohort of 2,447 HIV-seronegative pregnant women: a 24-month prospective study. J Pediatr Gastroenterol Nutr 2001; 33:570-5. [PMID: 11740231 DOI: 10.1097/00005176-200111000-00011] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Mother to infant transmission of hepatitis C virus (HCV) has been extensively studied in mothers with human immunodeficiency virus (HIV) infection, whereas fewer data are available on the vertical HCV transmission in HIV-negative women. METHODS Between January 1995 and June 1997, 78 consecutive HCV-positive/HIV-negative women with their offspring entered this prospective study aimed to define the prevalence of and risk factors for HCV vertical transmission. Risk factors for HCV were carefully sought, and HCV viral load and genotype were determined in all positive mothers. The infants were tested for alanine aminotransferase (ALT) and HCV-RNA at birth and at 4, 8, 12, 18, and 24 months of age. RESULTS Eight of 60 (13.3%) infants born to HCV-RNA positive mothers acquired HCV infection, but only 2 (3,3%) were still infected by the end of follow-up. Infants' genotypes matched that of the mothers. ALT levels were in the normal range in all study subjects throughout the follow-up. High maternal viral load (P < 0.05), possession of HCV risk factors (P < 0.004), and history of blood transfusion (P < 0.05) were associated with increased risk of HCV vertical transmission. CONCLUSIONS This long-term prospective study shows that, although vertical transmission from HIV-negative mothers occurs in 13% of cases, there is a high rate of spontaneous viral clearance (75%). High maternal viral load and mothers belonging to HCV risk categories were the only variables predictive of the vertical transmission.
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Affiliation(s)
- O Ceci
- Second Institute of Obstetrics and Gynaecology, University of Bari, Piazza Giulio Cesare, 11 70124 Bari, Italy
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20
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Gyuris Á Á, Segesdi J, Mezei M, Balog K, Jelenik Z, Takács M, Berencsi G, Földes I, Majtényi K, Kollár K, Minárovits J. Virological, Neurological and Histological Investigations of a Child Born to a Mother with AIDS. Pathol Oncol Res 2001; 3:303-308. [PMID: 11173652 DOI: 10.1007/bf02904291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
HIV-1 was isolated from a child at 6 and 9 months of age, proving the vertical transmission of infection from the mother with AIDS. The p24 antigen test of the plasma at 9 months of age was positive as well. A positive PCR reaction was detected in J34 cells, infected with the supernatant of the peripheral blood lymphocytes of the child. According to phenotypic characterization, the virus proved to be a SI (syncytium inducing) isolate, growing in PBL, MT2, J34 and other T and monocytic cell lines. The isolate was AZT sensitive. Two methods were applied for genotypic characterization: 1. Heteroduplex mobility assay (HMA), 2. Sequence analysis of a part of the env gene. On the basis of both of these methods, this virus belongs to the B subtype of HIV-1, which is prevalent mainly in Europe and in the USA. The neurological status of the child was followed regularly. At autopsy the presence of p24 antigen was detected in glial cells of the frontal cortex, proving the presence of the virus in the brain. A retardation of the development of the central nervous system could be observed as well.
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Affiliation(s)
- Ágnes Gyuris Á
- "Béla Johan" National Institute of Hygiene, Microbiological Research Group, Budapest, Hungary
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21
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Obert LA, Hoover EA. Feline immunodeficiency virus clade C mucosal transmission and disease courses. AIDS Res Hum Retroviruses 2000; 16:677-88. [PMID: 10791878 DOI: 10.1089/088922200308909] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The transmissibility and pathogenicity of a clade C feline immunodeficiency virus (FIV-C) was examined via the oral-nasal, vaginal, or rectal mucosa. FIV-C was transmissible by all three mucosal routes. Vaginal transmission was most efficient (100%), oral exposure resulted in a 80% infection rate, and rectal transmission was least effective (44%). In contrast to previous intravenous passage studies, a broader range of host-virus relationships was observed after mucosal exposure. Three categories of FIV-C infection were defined: (1) rapidly progressive infection marked by high virus burdens and rapid CD4+ cell depletion (43% of vaginally exposed animals); (2) conventional (typical) infection featuring slowly progressive CD4+ cell decline (61% of all exposed animals); and (3) regressive (transient) infection marked by low and then barely detectable virus burdens and no CD4+ cell alterations (22% of rectally inoculated cats). These disease courses appear to have parallels in mucosal HIV and SIV infections, emphasizing the importance of the virus-mucosa interface in lentiviral pathogenesis.
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Affiliation(s)
- L A Obert
- Department of Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins 80523, USA
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22
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Abstract
One of the most characteristic and, at the same time, puzzling features of the cellular immune response towards HIV-1 is represented by an early vigorous HIV-specific CD8+ CTL response that does not prevent disease progression in the vast majority of patients. In this context, there is a striking mismatch over the course of disease progression between increasing numbers of activated CD8+ T cells and apparent decrease of virus-specific CD8+ CTLs. Inhibitory NK receptors (iNKRs) specific for HLA class I molecules can be expressed on CD8+ T-cells of healthy individuals and deliver inhibitory signals that determine decreased CTL function. Their expression on CD8+ CTL may be induced by IL-15 or TGFP in vitro, and may represent an important regulatory function for the fine-tuning of the antigen-specific T cell response against tumors and intracytoplasmic pathogens. In HIV-1 infected patients, relevant proportions of peripheral blood CD8+ T lymphocytes express iNKRs belonging to the Ig superfamily (p58/p70/p140) and CD94/NKG2A. Presence of iNKRs on CD8+ CTLs impairs HIV-1-specific cytolytic activity in vitro and may allow uncontrolled viral replication and spread following functional inhibition of CTL effectors in infected patients.
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Affiliation(s)
- A De Maria
- Department of Internal Medicine, University of Genova, Italy
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23
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Wagner R, Leschonsky B, Harrer E, Paulus C, Weber C, Walker BD, Buchbinder S, Wolf H, Kalden JR, Harrer T. Molecular and Functional Analysis of a Conserved CTL Epitope in HIV-1 p24 Recognized from a Long-Term Nonprogressor: Constraints on Immune Escape Associated with Targeting a Sequence Essential for Viral Replication. THE JOURNAL OF IMMUNOLOGY 1999. [DOI: 10.4049/jimmunol.162.6.3727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
It has been hypothesized that sequence variation within CTL epitopes leading to immune escape plays a role in the progression of HIV-1 infection. Only very limited data exist that address the influence of biologic characteristics of CTL epitopes on the emergence of immune escape variants and the efficiency of suppression of HIV-1 by CTL. In this report, we studied the effects of HIV-1 CTL epitope sequence variation on HIV-1 replication. The highly conserved HLA-B14-restricted CTL epitope DRFYKTLRAE in HIV-1 p24 was examined, which had been defined as the immunodominant CTL epitope in a long-term nonprogressing individual. We generated a set of viral mutants on an HX10 background differing by a single conservative or nonconservative amino acid substitution at each of the P1 to P9 amino acid residues of the epitope. All of the nonconservative amino acid substitutions abolished viral infectivity and only 5 of 10 conservative changes yielded replication-competent virus. Recognition of these epitope sequence variants by CTL was tested using synthetic peptides. All mutations that abrogated CTL recognition strongly impaired viral replication, and all replication-competent viral variants were recognized by CTL, although some variants with a lower efficiency. Our data indicate that this CTL epitope is located within a viral sequence essential for viral replication. Targeting CTL epitopes within functionally important regions of the HIV-1 genome could limit the chance of immune evasion.
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Affiliation(s)
- Ralf Wagner
- *Institute of Medical Microbiology, University of Regensburg, Regensburg, Germany
| | - Bernd Leschonsky
- *Institute of Medical Microbiology, University of Regensburg, Regensburg, Germany
| | - Ellen Harrer
- †Department of Medicine III with Institute of Clinical Immunology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Christina Paulus
- *Institute of Medical Microbiology, University of Regensburg, Regensburg, Germany
| | - Christine Weber
- †Department of Medicine III with Institute of Clinical Immunology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Bruce D. Walker
- ‡Partners AIDS Research Center and Infectious Disease Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02129; and
| | - Susan Buchbinder
- §AIDS Office, Department of Public Health, San Francisco, CA 94140
| | - Hans Wolf
- *Institute of Medical Microbiology, University of Regensburg, Regensburg, Germany
| | - Joachim R. Kalden
- †Department of Medicine III with Institute of Clinical Immunology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Thomas Harrer
- †Department of Medicine III with Institute of Clinical Immunology, University of Erlangen-Nuremberg, Erlangen, Germany
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24
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Kirschner DE, Mehr R, Perelson AS. Role of the thymus in pediatric HIV-1 infection. JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY : OFFICIAL PUBLICATION OF THE INTERNATIONAL RETROVIROLOGY ASSOCIATION 1998; 18:95-109. [PMID: 9637574 DOI: 10.1097/00042560-199806010-00001] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Several lines of evidence suggest that HIV-1 is present in the thymus during HIV-1 infection. Precursors to mature CD4+ T lymphocytes develop in the thymus, which suggests that thymic infection may play a role in the CD4+ T-cell decline observed during the course of pediatric HIV-1 infection. We illustrate, through mathematical modeling, the potential effects of thymic infection on the course of pediatric AIDS disease progression. We find that infection in the thymus not only can supplement peripheral infection but can help explain the faster progression in pediatric cases, as well as the early and high viral burden.
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Affiliation(s)
- D E Kirschner
- Department of Microbiology, University of Michigan Medical School, Ann Arbor 48109-0620, USA.
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25
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Frenkel LM, Mullins JI, Learn GH, Manns-Arcuino L, Herring BL, Kalish ML, Steketee RW, Thea DM, Nichols JE, Liu SL, Harmache A, He X, Muthui D, Madan A, Hood L, Haase AT, Zupancic M, Staskus K, Wolinsky S, Krogstad P, Zhao J, Chen I, Koup R, Ho D, Korber B, Apple RJ, Coombs RW, Pahwa S, Roberts NJ. Genetic evaluation of suspected cases of transient HIV-1 infection of infants. Science 1998; 280:1073-7. [PMID: 9582120 DOI: 10.1126/science.280.5366.1073] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Detection of human immunodeficiency virus-type 1 (HIV-1) on only one or a few occasions in infants born to infected mothers has been interpreted to indicate that infection may be transient rather than persistent. Forty-two cases of suspected transient HIV-1 viremia among 1562 perinatally exposed seroreverting infants and one mother were reanalyzed. HIV-1 env sequences were not found in specimens from 20; in specimens from 6, somatic genetic analysis revealed that specimens were mistakenly attributed to an infant; and in specimens from 17, phylogenetic analysis failed to demonstrate the expected linkage between the infant's and the mother's virus. These findings argue that transient HIV-1 infection, if it exists, will only rarely be satisfactorily documented.
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Affiliation(s)
- L M Frenkel
- Department of Pediatrics, University of Rochester, Rochester, NY 14642, USA.
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26
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Abstract
Pregnancy in individuals infected with HIV has become an important problem because of a fourfold rise of infection in women of childbearing age in the developed world. The incidence of vertical transmission varies in different continents and is highest in Africa. Transmission may occur in utero (antepartum), during delivery (intrapartum), or after birth (postpartum), occurring during the latter period, in many cases, through breastfeeding. Maternal viral burden around the time of delivery is the strongest determinant of the risk of disease transmission. While breastfeeding may account for up to one-third of cases of vertical transmission in Africa, the benefits of breastfeeding outweigh its risks, even in HIV infection, and breastfeeding is recommended in those areas. Treatment of the mother with antiretroviral agents significantly decreases the risk of vertical transmission.
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Affiliation(s)
- D P Kotler
- Department of Medicine, St. Luke's-Roosevelt Hospital Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA
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27
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Abstract
Infection with HIV destroys the immune system and causes acquired immunodeficiency syndrome (AIDS). Death results from common bacterial and opportunistic infections that are rare in persons with a healthy immune system. HIV infection frequently is a fatal sexually transmitted disease that can also be transmitted from an infected mother to her offspring.
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Affiliation(s)
- V M Anderson
- Department of Pathology, State University of New York, Brooklyn, USA
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28
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Abstract
Prevention of mother-to-child transmission of HIV is a significant public health priority. A regimen of zidovudine administered during pregnancy, intrapartum, and to the newborn significantly reduces transmission, and incorporation of this regimen into clinical practice has been associated with significant decreases in perinatal transmission in industrialized countries. This regimen, however, is not applicable in the developing world (where most perinatal transmission occurs), and simpler, shorter, less costly regimens are urgently needed. An understanding of the pathogenesis of perinatal transmission is crucial for the design of new preventive and therapeutic regimens, and current knowledge is reviewed in this article, with an emphasis on relevance to prevention.
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Affiliation(s)
- L M Mofenson
- Pediatric, Adolescent, and Maternal AIDS Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
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29
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Abstract
Less than half of the paediatric HIV infections recorded in Australia have resulted from perinatal transmission, but in recent years this has been the predominant mode of infection. There are 136 infants who are known to have been exposed perinatally to HIV in Australia: 49 of these are infected. Caesarean section is thought now not to reduce the risk of perinatal transmission (PNT); rather, the risk increases with duration of membrane rupture and rises rapidly after 4 h of membrane rupture. However, no data exist to show that interventions to expediate delivery after membrane rupture reduce the risk of PNT. Data such as these suggest that the majority of perinatal infections (probably about 60%) occur close to the time of delivery. While the overall risk of PNT for non-breast fed infants is approximately 20-25%, the risk of infection for the infant is considerably increased when there is evidence of increased maternal viral burden. Advanced maternal disease predicts that if the infant is infected there is more likely to be early progression of HIV than is the case for the less frequently infected infants of mothers who are asymptomatic. Bottle feeding may prevent infection of 10% of children exposed perinatally. Use of zidovudine by the mother in the third trimester and i.v. zidovudine during labour, followed by oral zidovudine for the infant for 6 weeks can reduce the PNT rate by two thirds, to about 8%. Approximately 3% of uninfected infants with perinatal HIV exposure may be found to be transiently virus positive but eventually become antibody negative and thus appear to have eliminated the virus. The risk of Pneumocystis carinii pneumonitis (PCP) cannot be predicted on the basis of CD4 count and it is recommended that all children of infected mothers commence PCP prophylaxis around the age of 6 weeks-2 months and continue that therapy until the age of 12 months or until it becomes clear that the infant is uninfected. The cumulative risk of AIDS increases rapidly during the first year of life to about 20%, then more slowly at a rate of about 2 or 3% a year. The shape of this curve reveals the bimodal progression of HIV disease in children. About 15-20% of children rapidly develop a severe immune deficiency, opportunistic infections and, in most cases, encephalopathy. There is a very high morbidity rate in this group of children, most of whom die before the age of 3 or 4 years. In contrast, 80-85% of children only become immunodeficient after a relatively long period, which is similar to or perhaps even longer than that in adults. Recent studies indicate that zidovudine antiviral monotherapy is no longer appropriate. While no clear alternative to monotherapy has emerged most would, wherever possible, commence antiretroviral therapy with a combination of two or three drugs including zidovudine plus didanosine or lamivudine. If a third drug is used it would probably be a protease inhibitor.
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Affiliation(s)
- J B Ziegler
- Department of Immunology/Allergy, Sydney Children's Hospital, Randwick, New South Wales, Australia
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30
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O'Neil LL, Burkhard MJ, Obert LA, Hoover EA. Regression of feline immunodeficiency virus infection. AIDS Res Hum Retroviruses 1997; 13:713-8. [PMID: 9168240 DOI: 10.1089/aid.1997.13.713] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Regression of feline immunodeficiency virus (FIV) infection was observed in seven of nine vertically infected kittens born to two chronically infected mother cats. Both provirus and nonmaternal FIV antibody were detected in all kittens by 4 weeks of age but only three of the seven kittens were positive by blood mononuclear cell coculture. Between 10 and 14 months of age blood mononuclear cells from each of the seven cats were negative at least once by polymerase chain reaction (PCR), but evidence of virus infection was detected by coculture and/or PCR in biopsied lymph node or bone marrow from five of the seven cats. Despite this evidence of persistent tissue provirus, antibody production did not persist in any of the cats beyond 1 year of age. All seven cats remained asymptomatic although CD4 and CD8 T cell counts were in the low normal range throughout the study. By contrast, two additional perinatally infected littermates that were persistently virus isolation positive developed rapid CD4 depletion and progressed to terminal immunodeficiency by 9 weeks of age. Thus FIV infection can be downregulated and/or sequestered to extremely low levels barely detectable with the assays available, although absolute clearance of virus may not occur. These observations are relevant to human immunodeficiency virus (HIV) infection in paralleling both the apparent "regression" of HIV infection reported in some perinatally infected infants and the low-level, apparently stable, infection established by attenuated simian immunodeficiency viruses.
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Affiliation(s)
- L L O'Neil
- Department of Pathology, Colorado State University, Fort Collins 80523, USA
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31
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Rich KC, Siegel JN, Jennings C, Rydman RJ, Landay AL. Function and phenotype of immature CD4+ lymphocytes in healthy infants and early lymphocyte activation in uninfected infants of human immunodeficiency virus-infected mothers. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 1997; 4:358-61. [PMID: 9144377 PMCID: PMC170532 DOI: 10.1128/cdli.4.3.358-361.1997] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The function and phenotypes of CD4+ lymphocytes in infants are different than in adults and are modulated by maturational changes and exposure to environmental antigens. Infants of non-human immunodeficiency virus (HIV)-infected mothers and uninfected infants of HIV-infected mothers, 0 to 6 months of age, were examined for CD4+ lymphocyte function by in vitro interleukin-2 (IL-2) production and for CD4+ phenotypes by three-color flow cytometry. A minority of these uninfected infants (28%) had functional responses similar to those of healthy adult women (IL-2 production in response to anti-CD3, alloantigen, and mitogen), while the remainder were capable of responding to alloantigen and mitogen but not to anti-CD3. We did demonstrate reduced phytohemagglutinin-stimulated IL-2 production in uninfected infants born to HIV-seropositive mothers compared to that in infants from seronegative mothers. The proportions of CD3+ CD4+, CD4+ HLA-DR- CD38+, and CD4+ CD45RA+ RO- (naive) lymphocytes were much higher in infants than in adults, and the proportions of CD4+ CD45RA- RO+ (memory) and CD4+ CD25+ (IL-2 receptor-bearing) lymphocytes were lower in infants than in adults. The proportions of activated (CD4+ HLA-DR+ CD38+) and memory (CD4+ CD45RA- RO+) lymphocytes were increased in uninfected infants of HIV-infected mothers compared to infants of uninfected mothers. Therefore, T-helper-cell function is immature in many infants, but the CD4+ lymphocytes of some HIV-exposed, uninfected infants have been stimulated by antigen at an early age.
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Affiliation(s)
- K C Rich
- Department of Pediatrics, University of Illinois at Chicago, USA
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32
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Willett BJ, Flynn JN, Hosie MJ. FIV infection of the domestic cat: an animal model for AIDS. IMMUNOLOGY TODAY 1997; 18:182-9. [PMID: 9136455 DOI: 10.1016/s0167-5699(97)84665-8] [Citation(s) in RCA: 143] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- B J Willett
- Dept of Veterinary Pathology, University of Glasgow Veterinary School, UK.
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33
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Biggar RJ, Miley W, Miotti P, Taha TE, Butcher A, Spadoro J, Waters D. Blood collection on filter paper: a practical approach to sample collection for studies of perinatal HIV transmission. JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY : OFFICIAL PUBLICATION OF THE INTERNATIONAL RETROVIROLOGY ASSOCIATION 1997; 14:368-73. [PMID: 9111480 DOI: 10.1097/00042560-199704010-00010] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The use of dried blood spots lends itself to widespread application in large field studies, especially in remote areas. We present experience gained during a perinatal HIV transmission study in southern Africa in which dried blood spot samples were used for polymerase chain reaction (PCR) tests. In this study, 15,810 filter paper cards with dried blood spots were collected. Infants were seen at age 6 and 12 weeks, and PCR was routinely done in duplicate on each sample. Of 186 negative controls (infants born to HIV-negative women), two (1.1%) had a single strongly reactive PCR result; the repeated duplicates were both negative. In contrast, all 24 known positive samples were strongly positive in both tests. Results were available from 1,976 duplicate tests on 1,235 infants born to HIV-infected women. Based on the PCR result on a later sample, the positive predictive value was 97.6% if both replicates were strongly positive (absorbance: 0.8 OD450 U), 100% when one of the replicates was strongly positive, and 27% when one or both replicates were weakly positive (but none strongly positive). When both replicates were negative, the negative predictive value was > or = 96.2%. Thus, when a single HIV PCR test has a strongly positive result, the infant is very likely to be infected. A positive PCR result after age 1 month was 98.9% accurate in predicting antibody positivity after 15 months. Suggestions for sample collection, storage, and PCR testing are provided.
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Affiliation(s)
- R J Biggar
- Viral Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
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34
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Okamoto Y, Shiosaki K, Eda Y, Tokiyoshi S, Yamaguchi Y, Gojobori T, Hachimori T, Yamazaki S, Hondo M. Father-to-mother-to-infant transmission of HIV-1: clonally transmitted isolate of infant mutates more rapidly than that of the mother and rapidly loses reactivity with neutralizing antibody. Microbiol Immunol 1997; 41:131-8. [PMID: 9087955 DOI: 10.1111/j.1348-0421.1997.tb01178.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The sequences of the V3 loop and surrounding regions of human immunodeficiency virus type-1 from a father-to-mother-to-infant trimmer were studied and the horizontal and vertical transmissions compared. The father's virus was variable for reactivity with neutralizing antibody and sequences of the V3 loop central core sequence. In contrast, the mother's viral sequences were much less diverse and reacted with a virus neutralizing antibody. The infant's viral sequences were also less diverse than those of the father, and N-glycosylation sites were conserved. By phylogenetic analysis, the major clone, of which V3-peptide reacted with the neutralizing antibody, was found to be transmitted from the mother to her infant; however, the mutated minor clones did not bind to the antibody. These findings suggest that both horizontal and vertical virus transmission were selective, and that the clonally transmitted virus in infants mutates more rapidly than viruses in the mother, to whom the virus was horizontally transmitted.
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Affiliation(s)
- Y Okamoto
- Laboratory of Immunology, AIDS Research Center, National Institute of Health, Tokyo, Japan
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35
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Hosie MJ, Flynn JN. Feline immunodeficiency virus vaccination: characterization of the immune correlates of protection. J Virol 1996; 70:7561-8. [PMID: 8892875 PMCID: PMC190824 DOI: 10.1128/jvi.70.11.7561-7568.1996] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Whole inactivated virus (WIV) vaccines derived from the FL4 cell line protect cats against challenge with feline immunodeficiency virus (FIV). To investigate the correlates of protective immunity induced by WIV, we established an immunization regimen which protected a proportion of the vaccinates against challenge. A strong correlation was observed between high virus neutralizing antibody titers and protection following challenge. To investigate further the immune mechanisms responsible for immunity, all of the vaccinates were rechallenged 35 weeks following the initial challenge. Results of virus isolation from peripheral blood mononuclear cells indicated that 9 of 10 vaccinates were protected from viremia following the second challenge, suggesting that vaccine-induced immunity to FIV persisted for at least 8 months. However, more stringent analysis for evidence of infection revealed that 5 of 10 vaccinates harbored virus in lymphoid tissues. Unlike the protection observed immediately following vaccination, which correlated positively with virus neutralizing antibody titer, the ability to resist a second challenge with FIV was more closely correlated with the induction of Env-specific cytotoxic T-cell activity. The results indicate that both virus-specific humoral immunity and cellular immunity play a role in the protection induced in cats by WIV immunization but their relative importance may be dependent on the interval between vaccination and exposure to virus.
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Affiliation(s)
- M J Hosie
- MRC Retrovirus Research Laboratory, Department of Veterinary Pathology, University of Glasgow, Bearsden, United Kingdom.
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36
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Abstract
By the year 2000 there will be six million pregnant women and five to ten million children infected with HIV-1. Intervention strategies have been planned and in some instances already started. A timely and cost-effective strategy needs to take into account that most HIV-1 infected individuals reside in developing countries. Further studies are needed on immunological and virological factors affecting HIV-1 transmission from mother to child, on differential disease progression in affected children, and on transient infection.
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Affiliation(s)
- G Scarlatti
- Laboratory of Immunobiology, Centro San Luigi, San Raffaele Scientific Institute, Milan, Italy
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Long SS, Lischner HW. Early and accurate detection of infection with human immunodeficiency virus type 1 in vertically exposed infants. J Pediatr 1996; 129:189-90. [PMID: 8765613 DOI: 10.1016/s0022-3476(96)70239-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Affiliation(s)
- B R Bloom
- Howard Hughes Medical Institute, Department of Microbiology, Albert Einstein College of Medicine, Bronx, New York 10461, USA
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Affiliation(s)
- John B Ziegler
- Department of Immunology and AllergySydney Children's HospitalSydneyNSW
| | - Stéphane Blanche
- Unité d'Immunologie–Hématologie PédiatriqueHôpital Necker‐Enfants MaladesParisFrance
| | - Richard Loh
- Department of ImmunologyPrincess Margaret Hospital for ChildrenPerthWA
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Abstract
A great deal of progress has been made in our understanding of mother-to-child transmission of HIV-1. Standardization of case definitions and transmission rate calculation methodologies, and a broader array of diagnostic options for detection of infant HIV-1 infection, will enhance our ability to evaluate and compare cohorts worldwide. In the next decade, several intervention studies should be completed. Carefully designed intervention studies have the potential both to determine which interventions are effective as well as to add to our understanding of vertical transmission of HIV-1. Regional differences in vertical transmission rates reflect a variety of viral, host, and obstetric factors. Intervention strategies will probably need to be regionally designed, taking into consideration these factors. Further research on timing and correlates of vertical transmission is necessary to determine the extent to which specific clinical trials can be extrapolated to public health policy.
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Affiliation(s)
- G C John
- Department of Medicine, University of Washington, Seattle 98195, USA
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