Vertical transmission of human immunodeficiency virus

Acta Microbiol Immunol Hung. 2001;48(3-4):413-27. doi: 10.1556/AMicr.48.2001.3-4.10.

Abstract

Sensitive detection methods, such as DNA PCR and RNA PCR suggest that vertical transmission of human immunodeficiency virus (HIV) occurs at three major time periods; in utero, around the time of birth, and postpartum as a result of breastfeeding (Fig. 1). Detection of proviral DNA in infant's blood at birth suggests that transmission occurred prior to delivery. A working definition for time of infection is that HIV detection by DNA PCR in the first 48 h of life indicates in utero transmission, while peripartum transmission is considered if DNA PCR is negative the first 48 h, but then it is positive 7 or more days later [1]. Generally, in the breastfeeding population, breast milk transmission is thought to occur if virus is not detected by PCR at 3-5 months of life but is detected thereafter within the breastfeeding period [2]. Using these definitions and guidelines, studies has suggested that in developed countries the majority, or two thirds of vertical transmission occur peripartum, and one-third in utero [3-6]. The low rate of breastfeeding transmission is due to the practice of advising known HIV-positive mothers not to feed breast milk. However, since the implementation of antiretroviral treatment in prophylaxis of HIV-positive mothers, some studies have suggested that in utero infection accounts for a larger percentage of vertical transmissions [7]. In developing countries, although the majority of infections occurs also peripartum, a significant percentage, 10-17%, is thought to be due to breastfeeding [2, 8, 9].

Publication types

  • Review

MeSH terms

  • Breast Feeding / adverse effects
  • DNA, Viral / blood
  • DNA, Viral / genetics
  • Delivery, Obstetric
  • Extraembryonic Membranes / virology
  • Female
  • Fetal Blood / virology
  • Genetic Variation
  • HIV Infections / immunology
  • HIV Infections / transmission*
  • HIV Infections / virology
  • HIV-1 / genetics
  • HIV-1 / isolation & purification
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical
  • Labor, Obstetric
  • Placenta / virology
  • Polymerase Chain Reaction
  • Pregnancy
  • Pregnancy Complications, Infectious* / immunology
  • Pregnancy Complications, Infectious* / virology
  • Proviruses / genetics
  • Proviruses / isolation & purification

Substances

  • DNA, Viral