Pediatr Infect Dis J. 2018 Mar;37(3):246-252. doi: 10.1097/INF.0000000000001749.
HIV-1 infection may impair transplacental antibody transfer to infants. The impact of highly active antiretroviral treatment (ART) given during pregnancy on transplacental antibody transport is unknown.
HIV-1 infected pregnant women with CD4 counts between 200 - 500 were randomized to short-course zidovudine (ZDV) or triple ART at 32 weeks gestation for prevention of mother-to-child HIV-1 transmission. Levels of maternal antibody against measles, pneumococcus and rotavirus at delivery, and antibody transfer to the baby through cord blood, were compared between trial arms.
Overall, 141 and 148 women were randomized to triple ART and ZDV, respectively; cord blood was available for a subset (n = 20 in triple ART and n = 22 in ZDV). Maternal antibody levels to all pathogens during pregnancy and at delivery were not significantly different between arms. Within each arm, antibody levels at delivery were lower than at enrolment. For all antibodies, a woman's levels before delivery were an important predictor of amount transferred to her infant. Women on triple ART transferred higher levels of pathogen-specific antibodies when compared with women on short course ZDV.
Women on triple ART transferred higher levels of pathogen-specific antibodies compared with women on ZDV alone.
HIV-1 感染可能会影响母体向婴儿的抗体转移。尚不清楚在孕期进行高效抗逆转录病毒治疗（ART）对胎盘抗体转运的影响。
将 CD4 计数在 200-500 之间的 HIV-1 感染孕妇随机分为短程齐多夫定（ZDV）或三联 ART 组，于妊娠 32 周进行治疗，以预防母婴 HIV-1 传播。比较试验组之间分娩时母体针对麻疹、肺炎球菌和轮状病毒的抗体水平以及通过脐血向婴儿的抗体转移。
总体而言，141 名和 148 名妇女分别随机分配至三联 ART 和 ZDV 组；在三联 ART 组中有 20 名和在 ZDV 组中有 22 名妇女的脐血可用于亚组分析。妊娠期间和分娩时所有病原体的母体抗体水平在各组间无显著差异。在每组内，分娩时的抗体水平均低于入组时的水平。对于所有抗体，分娩前妇女的抗体水平是向婴儿转移量的重要预测因素。与接受短期 ZDV 治疗的妇女相比，接受三联 ART 治疗的妇女转移了更高水平的病原体特异性抗体。
与单独使用 ZDV 相比，接受三联 ART 治疗的妇女转移了更高水平的病原体特异性抗体。
