Department of Paediatrics and Child Health, University of Nairobi, Nairobi 00202, Kenya.
Clin Perinatol. 2010 Dec;37(4):787-805, ix. doi: 10.1016/j.clp.2010.08.005.
Despite more than 2 decades of research, an effective vaccine that can prevent HIV-1 infection in populations exposed to the virus remains elusive. In the pursuit of an HIV-1 vaccine, does prevention of exposure to maternal HIV-1 in utero, at birth or in early life through breast milk require special consideration? This article reviews what is known about the immune mechanisms of susceptibility and resistance to mother-to-child transmission (MTCT) of HIV-1 and summarizes studies that have used passive or active immunization strategies to interrupt MTCT of HIV-1. Potentially modifiable infectious cofactors that may enhance transmission and/or disease progression (especially in the developing world) are described. An effective prophylactic vaccine against HIV-1 infection needs to be deployed as part of the Extended Program of Immunization recommended by the World Health Organization for use in developing countries, so it is important to understand how the infant immune system responds to HIV-1 antigens, both in natural infection and presented by candidate vaccines.
尽管已经进行了 20 多年的研究，但仍然难以开发出一种能够预防人群感染 HIV-1 的有效疫苗。在寻找 HIV-1 疫苗的过程中，通过母婴阻断（产前、产时及哺乳期）来预防母婴 HIV-1 感染是否需要特别考虑？本文回顾了对 HIV-1 母婴垂直传播（MTCT）易感性和抵抗力的免疫机制的认识，并总结了应用被动或主动免疫策略来阻断 HIV-1 母婴传播的研究。本文还描述了可能增强传播和/或疾病进展的可改变的传染性协同因素（尤其是在发展中国家）。有效的预防性 HIV-1 感染疫苗需要作为世界卫生组织推荐的扩大免疫规划的一部分来进行部署，因此了解婴儿免疫系统对 HIV-1 抗原的反应（无论是在自然感染中还是在候选疫苗中）非常重要。
