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

Omayma Amin1, Jenna Powers1, Katherine M Bricker1

  • 1Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States.

Frontiers in Immunology
|November 8, 2021
PubMed

Insights

Preventing mother-to-child HIV transmission is crucial, as over 150,000 children were infected in 2019. Understanding transmission routes and immune factors is key to developing a pediatric HIV cure.

Area of Science:

  • Pediatric infectious diseases
  • Immunology
  • Virology

Background:

  • Mother-to-child transmission (MTCT) is the primary cause of pediatric HIV infection.
  • In 2019, over 150,000 children were infected with HIV globally.
  • Current prevention strategies require enhancement, and a pediatric HIV cure is needed.

Purpose of the Study:

  • To summarize the unique aspects of HIV MTCT.
  • To explore the immunopathogenesis of different transmission routes.
  • To understand how MTCT impacts early immune responses and HIV persistence.

Main Methods:

  • Review of existing literature on HIV mother-to-child transmission.
  • Analysis of immunopathogenesis across antenatal, intrapartum, and postnatal transmission routes.
  • Examination of maternal and infant factors influencing HIV infection and persistence.

Main Results:

  • HIV transmission occurs via three routes: in utero, intrapartum, and postnatal (breastfeeding).
  • Transmission rates without intervention range from 15% to 45%.
  • Maternal or fetal immune factors, like HIV-specific antibodies, may influence transmission outcomes.

Conclusions:

  • A deeper understanding of viral, maternal, and infant interactions is essential.
  • This knowledge can guide the development of strategies for a pediatric HIV cure.
  • Continued research is vital for eliminating vertical HIV infection and achieving a cure.

Keywords:
HIVMTCTantiretroviralbreast milkcurepediatricreservoirshock and kill

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