Ehrnst A, Lindgren S, Dictor M, Johansson B, Sönnerborg A, Czajkowski J, Sundin G, Bohlin A B
Department of Virology, Central Microbiological Laboratory of the Stockholm County Council, Sweden.
Lancet. 1991 Jul 27;338(8761):203-7. doi: 10.1016/0140-6736(91)90347-r.
To assess the role of maternal viraemia in vertical transmission of HIV and the extent to which viraemia occurs during the various stages of pregnancy, we have attempted to detect human immunodeficiency virus (HIV) in 44 pregnant HIV-1 infected women during 47 pregnancies (30 continued, 17 aborted) and in 30 children and 12 fetuses. Infectious HIV was detected at some time during pregnancy in 59% of women from plasma and in 83% from either peripheral blood mononuclear cells or plasma. HIV was not isolated from any of the newborn babies (0/27) at birth. The mothers had a significantly higher frequency of viraemia during pregnancy than their children had by 6 months of age (p = 0.002); by this time HIV was recovered from 5 (26%) of 19 infants. HIV was not detected by virus isolation, in-situ hybridisation, or polymerase chain reaction (PCR) in 10 fetuses; the other 2 fetuses were positive either by in-situ hybridisation or by PCR but neither result could be confirmed in a second organ or by the other methods of detection. The findings show that there is no consistent spread of HIV across the placenta during maternal viraemia, and indicate that in most cases transmission occurs close to or at delivery.
为评估母体病毒血症在人类免疫缺陷病毒（HIV）垂直传播中的作用以及孕期各阶段病毒血症发生的程度，我们试图在44名感染HIV - 1的孕妇的47次妊娠期间（30例继续妊娠，17例流产）以及30名儿童和12名胎儿中检测HIV。在孕期的某个时间，59%的孕妇血浆中检测到传染性HIV，83%的孕妇外周血单核细胞或血浆中检测到传染性HIV。出生时，未从任何新生儿（0/27）中分离出HIV。孕妇孕期病毒血症的发生率显著高于其6个月大的孩子（p = 0.002）；此时，19名婴儿中有5名（26%）检测到HIV。10名胎儿经病毒分离、原位杂交或聚合酶链反应（PCR）检测未发现HIV；另外2名胎儿原位杂交或PCR检测呈阳性，但在第二个器官或用其他检测方法均无法证实检测结果。研究结果表明，母体病毒血症期间HIV不会持续通过胎盘传播，提示在大多数情况下，传播发生在临近分娩或分娩时。
