Báo cáo sinh học: Maternal plasma viral load and neutralizing/enhancing antibodies in vertical transmission of HIV: A non-randomized prospective study

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Báo cáo sinh học: " Maternal plasma viral load and neutralizing/enhancing antibodies in vertical transmission of HIV: A non-randomized prospective study"Virology Journal BioMed Central Open AccessResearchMaternal plasma viral load and neutralizing/enhancing antibodies invertical transmission of HIV: A non-randomized prospective studyPaul Kamara1, Loyda Melendez-Guerrero2, Miguel Arroyo3, Heidi Weiss4 andPauline Jolly*1Address: 1Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1665 University Blvd., Ryals Building,Room 217, Birmingham AL 35294-0022, USA, 2Department of Microbiology and Medical Zoology, University of Puerto Rico, Medical SciencesCampus, School of Medicine, San Juan, Puerto Rico, 3US Military HIV Research Program, Walter Reed Army Institute of Research, Division ofRetrovirology, Silver Spring, MD 20910, USA and 4Breast Center, Baylor College of Medicine, One Baylor Plaza, MS: BCM 600, 335A, Houston,TX 77030, USAEmail: Paul Kamara - PaulKamara@westat.com; Loyda Melendez-Guerrero - lmelendez@rcm.upr.edu;Miguel Arroyo - marroyo@hivresearch.org; Heidi Weiss - hweiss@breastcenter.tmc.edu; Pauline Jolly* - jollyp@uab.edu* Corresponding authorPublished: 24 February 2005 Received: 05 October 2004 Accepted: 24 February 2005Virology Journal 2005, 2:15 doi:10.1186/1743-422X-2-15This article is available from: http://www.virologyj.com/content/2/1/15© 2005 Kamara et al; licensee BioMed Central Ltd.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.HIV vertical transmissionHIV neutralizationmaternal viral loadHIV enhancement Abstract Background: We examined the association and interaction between maternal viral load and antibodies in vertical transmission of HIV in a non-randomized prospective study of 43 HIV-1 infected pregnant women who attended the San Juan City Hospital, Puerto Rico, and their 45 newborn infants. The women and infants received antiretroviral therapy. Methods: A nested PCR assay of the HIV-1 envelope V3 region and infant PBMC culture were performed to determine HIV status of the infants. Maternal and infant plasma were tested for HIV neutralization or enhancement in monocyte-derived macrophages. Results: Twelve (26.7%) infants were positive by the HIV V3 PCR assay and 3 of the 12 were also positive by culture. There was a trend of agreement between high maternal viral load and HIV transmission by multivariate analysis (OR = 2.5, CI = 0.92, p = 0.0681). Both maternal and infant plasma significantly (p = 0.001 for both) reduced HIV replication at 10-1 dilution compared with HIV negative plasma. Infant plasma neutralized HIV (p = 0.001) at 10-2 dilution but maternal plasma lost neutralizing effect at this dilution. At 10-3 dilution both maternal and infant plasma increased virus replication above that obtained with HIV negative plasma but only the increase by maternal plasma was statistically significant (p = 0.005). There were good agreements in enhancing activity in plasma between mother-infant pairs, but there was no significant association between HIV enhancement by maternal plasma and vertical transmission. Conclusion: Although not statistically significant, the trend of association between maternal viral load and maternal-infant transmission of HIV supports the finding that viral load is a predictor of maternal-infant transmission. Both maternal and infant plasma neutralized HIV at low dilution and enhanced virus replication at high dilution. The antiretroviral treatments that the women received and the small sample size may have contributed to the lack of association between HIV enhancement by maternal plasma and vertical transmission. Page 1 of 10 (page number not for citation purposes)Virology Journal 2005, 2:15 ...