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Isolation of Leukocytes from Human Breast Milk for Use in an Antibody-dependent Cellular Phagocytosis Assay of HIV Targets
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Mother-to-child transmission of HIV-1: timing and implications for prevention

Athena P Kourtis1, Francis K Lee, Elaine J Abrams

  • 1Division of Reproductive Health, Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. apk3@cdc.gov

The Lancet. Infectious Diseases
|October 28, 2006
PubMed

Insights

Mother-to-child HIV-1 transmission occurs late in pregnancy for non-breastfeeding infants. For breastfeeding infants, transmission primarily happens postnatally, highlighting the need for targeted interventions.

Area of Science:

  • Virology
  • Epidemiology
  • Public Health

Background:

  • Mother-to-child transmission of Human Immunodeficiency Virus type 1 (HIV-1) remains a significant challenge, particularly in developing nations.
  • Breastfeeding is a major route for paediatric HIV/AIDS transmission, necessitating distinct prevention strategies.

Purpose of the Study:

  • To synthesize clinical trial data to determine the timing of HIV-1 transmission from mother to child.
  • To provide separate transmission timing estimates for breastfeeding and non-breastfeeding populations.
  • To explore the implications of viral latency on transmission dynamics.

Main Methods:

  • Analysis of existing clinical trial data on mother-to-child HIV-1 transmission.
  • Estimation of transmission timing based on breastfeeding status.
  • Review of recent research on viral latency and its potential impact on infection establishment.

Main Results:

  • In non-breastfeeding populations, approximately 50% of HIV-1 infections are transmitted late in pregnancy or during labor.
  • In breastfeeding populations, the majority of HIV-1 transmissions occur during the postnatal period.
  • Viral latency may decouple initial fetal exposure from established infection.

Conclusions:

  • Understanding transmission timing is crucial for effective prevention of mother-to-child HIV-1 transmission (PMTCT).
  • Exclusive breastfeeding for the first six months could potentially reduce postnatal transmission rates.
  • The concept of viral latency offers new avenues for developing innovative PMTCT interventions.

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