Luzuriaga Katherine, Newell Marie-Louise, Dabis Francois, Excler Jean-Louis, Sullivan John L
University of Massachusetts Medical School, Program in Molecular Medicine, 373 Plantation Street, Suite 318, Worcester, MA 01605, USA.
Lancet. 2006 Aug 5;368(9534):511-21. doi: 10.1016/S0140-6736(06)69159-9.
Mother-to-child transmission (MTCT) of HIV-1 is the major mode of paediatric infection. The rapidly increasing incidence of MTCT worldwide has resulted in an urgent need for preventive strategies. Antiretroviral regimens can prevent intrapartum HIV transmission; however, these regimens do not prevent HIV transmission through breastfeeding. Furthermore, children who escape MTCT are again at risk of infection when they become sexually active as adolescents. An infant vaccine regimen, begun at birth, would hence be a more attractive strategy and might also provide the basis for lifetime protection. Unique features of MTCT and paediatric HIV disease could be helpful in understanding correlates of immune protection and could facilitate rapid assessment of vaccine efficacy. Thus, there is compelling rationale to develop safe, effective HIV vaccines for use in infants and children. Here, we discuss the scientific and logistical challenges for the development of paediatric HIV vaccines; available vaccines and completed or planned paediatric vaccine trials are also discussed.
人类免疫缺陷病毒1型（HIV-1）的母婴传播（MTCT）是儿童感染的主要途径。全球范围内MTCT发病率的迅速上升导致迫切需要预防策略。抗逆转录病毒疗法可以预防分娩期间的HIV传播；然而，这些疗法并不能预防通过母乳喂养传播的HIV。此外，未发生MTCT的儿童在青少年时期开始性活跃时再次面临感染风险。因此，从出生就开始的婴儿疫苗接种方案将是一个更具吸引力的策略，也可能为终身保护提供基础。MTCT和儿童HIV疾病的独特特征有助于理解免疫保护的相关因素，并有助于快速评估疫苗效力。因此，开发用于婴幼儿的安全、有效的HIV疫苗具有令人信服的理由。在此，我们讨论开发儿童HIV疫苗面临的科学和后勤挑战；还讨论了现有的疫苗以及已完成或计划中的儿童疫苗试验。
