Ellington Sascha R, King Caroline C, Kourtis Athena P
Division of Reproductive Health, National Center for Chronic Disease Prevention & Health Promotion, CDC, 4770 Buford Highway, NE, MS K34, Atlanta, GA 30341, USA.
Future Virol. 2011;6(2):1451-1469. doi: 10.2217/fvl.11.119. Epub 2011 Nov 24.
Mother-to-child transmission (MTCT) is the most important mode of HIV-1 acquisition among infants and children and it can occur , intrapartum and postnatally through breastfeeding. Great progress has been made in preventing MTCT through use of antiretroviral regimens during gestation, labor/delivery and breastfeeding. The mechanisms of MTCT, however, are multifactorial and remain incompletely understood. This review focuses on select host factors affecting MTCT, in particular genetic factors, coexisting infections, behavioral factors and nutrition. Whereas much emphasis has been placed on decreasing maternal HIV-1 viral load, an important determinant of MTCT, through use of antiretroviral agents, complementary focus on overall maternal health is often neglected. By addressing coinfections in mothers and infants, improving the mother's nutritional status and modifying risky behaviors and practices, not only is maternal and child health improved, but a direct benefit in reducing MTCT can be derived. The study of genetic variations in susceptibility to HIV-1 infection is rapidly evolving, and the future is likely to bring revolutionary changes in HIV-1 prevention by enhancing natural resistance to infection and by individually tailoring pharmacologic regimens.
母婴传播（MTCT）是婴幼儿感染HIV-1的最重要途径，可在分娩期间及产后通过母乳喂养发生。在孕期、分娩期和哺乳期使用抗逆转录病毒疗法预防母婴传播方面已取得了巨大进展。然而，母婴传播的机制是多因素的，仍未完全明确。本综述重点关注影响母婴传播的特定宿主因素，尤其是遗传因素、合并感染、行为因素和营养。虽然人们非常强调通过使用抗逆转录病毒药物降低作为母婴传播重要决定因素的母亲HIV-1病毒载量，但往往忽视了对母亲整体健康的补充关注。通过处理母婴的合并感染、改善母亲的营养状况以及改变危险行为和做法，不仅可以改善母婴健康，还能直接降低母婴传播率。对HIV-1感染易感性的基因变异研究正在迅速发展，未来通过增强自然抗感染能力和个性化定制药物治疗方案，可能会给HIV-1预防带来革命性变化。
