Luzuriaga K, McQuilken P, Alimenti A, Somasundaran M, Hesselton R, Sullivan J L
Program in Molecular Medicine, University of Massachusetts Medical School, Worcester 01605.
J Infect Dis. 1993 May;167(5):1008-13. doi: 10.1093/infdis/167.5.1008.
Thirty-three infants born to human immunodeficiency virus type 1 (HIV-1)-seropositive women were evaluated from birth using plasma and peripheral blood mononuclear cell (PBMC) cultures, polymerase chain reaction, and serum p24 antigen assays. Five children were identified as infected. Evidence of infection was found in cord blood and subsequent samples from 2 infected children, suggesting in utero infection. Virologic studies on cord blood and early neonatal specimens from the 3 other infected children were negative but became positive by 8 weeks of age, suggesting either intrapartum transmission or sequestration of virus with subsequent detection. An increase in blood (plasma and PBMC) virus titers consistent with primary viremia was observed in 4 infants between 3 and 16 weeks of age. Blood virus titers subsequently declined in the absence of antiretroviral therapy and in the absence of activated HIV-1-specific cytotoxic T lymphocyte responses or broadly neutralizing antibodies. Confirmation of these results in larger studies may be helpful in the design of clinical trials to interrupt vertical transmission or to modify the course of infection.
对33名出生于人类免疫缺陷病毒1型（HIV-1）血清反应阳性女性的婴儿，从出生起就使用血浆和外周血单个核细胞（PBMC）培养、聚合酶链反应以及血清p24抗原检测进行评估。5名儿童被确定为感染。在2名感染儿童的脐带血及后续样本中发现了感染证据，提示宫内感染。对另外3名感染儿童的脐带血和早期新生儿样本进行的病毒学研究呈阴性，但在8周龄时转为阳性，提示可能是分娩时传播或病毒隐匿随后被检测到。在4名3至16周龄的婴儿中观察到血液（血浆和PBMC）病毒载量增加，与原发性病毒血症一致。在没有抗逆转录病毒治疗、没有活化的HIV-1特异性细胞毒性T淋巴细胞反应或广泛中和抗体的情况下，血液病毒载量随后下降。在更大规模的研究中证实这些结果可能有助于设计临床试验以阻断垂直传播或改变感染进程。
