Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Maternal HIV-1 viral load and vertical transmission of infection: The Ariel Project for the prevention of HIV transmission from mother to infant

Nature Medicine volume 3, pages 549–552 (1997)Cite this article

Abstract

Most HIV-1 infections of children result from mother-to-infant transmission, which may occur perinatally or postnatally, as a consequence of breast feeding1–8. In this study, the influence of maternal viral load on transmission of infection to infants from non-breast-feeding mothers was examined using samples of plasma and peripheral blood mononuclear cells (PBMCs) collected at several time points during pregnancy and the 6-month period after delivery. These samples were analyzed by several quantitative methods, including virus cultures of PBMCs and polymerase chain reaction (PCR) assays for HIV-1 RNA in plasma and DMA in PBMCs. The risk of transmission increased slightly with a higher viral load, but transmission and nontransmission occurred over the entire range of values for each assay. No threshold value of virus load was identified which discriminated between transmitters and nontransmitters. We also noted a significant rise in viral load and a decline in CD4+ lymphocytes in the six months after delivery. These findings suggest that a high maternal viral load is insufficient to fully explain vertical transmission of HIV-1. Additional studies are needed to examine the post-partum increase in viremia.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Mofenson, L.M. Epidemiology and determinants of vertical HIV transmission. Semin. Pediatr. Infect. Dis. 5, 252–265 (1994).

    Google Scholar 

  2. Peckham, C. & Gibb, D. Mother to child transmission of the human immunodeficiency virus. N. Engl. J. Med. 333, 298–302 (1995).

    Article  CAS  Google Scholar 

  3. Von Siedlein, L., & Bryson, Y.J., Maternal-fetal transmission of the human immunodeficiency virus type 1. Semin. Pediatr. Infect. Dis. 5, 78–86 (1994).

    Google Scholar 

  4. Stiehm, E.R. & Vink, P. Transmission of human immunodeficiency virus infection by breast-feeding. J. Pediatr. 118, 410–412 (1991).

    Article  CAS  Google Scholar 

  5. Ziegler, J.B., Cooper, D.A., Johnson, R.O. & Gold, J. Postnatal transmission of AIDS-associated retrovirus from mother to Infant. Lancet 1, 896–898 (1985).

    Article  CAS  Google Scholar 

  6. Academy of Pediatrics. Human milk, breastfeeding, and transmission of human immunodeficiency virus in the United States. Pediatrics 96, 977–979 (1995).

  7. Dunn, D.T., Newell, M.L. & Peckham, C.S. Risk of human immunodeficiency virus type 1 transmission through breastfeeding. Lancet 340, 585–588 (1992).

    Article  CAS  Google Scholar 

  8. Sprecher, S., Soumenkoff, G., Puissant, F. & Degueldre, M. Vertical transmission of HIV in a 15-week fetus [letter]. Lancet ii, 288–289 (1986).

    Article  Google Scholar 

  9. Connor, E.M. et al. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. N. Engl. J. Med. 331, 1173–1180 (1994).

    Article  CAS  Google Scholar 

  10. Recommendations of the U.S. Public Health Service Task Force on the use of zidovudine to reduce perinatal transmission of human immunodeficiency virus. MMWR Morb. Mortal. Wkly. Rep. 43, 1–20 (1994).

  11. Dickover, R.E. et al. Identification of levels of maternal HIV-1 RNA associated with risk of perinatal transmission. Effect of maternal zidovudine treatment on viral load. JAMA 275, 599–605 (1996).

    Article  CAS  Google Scholar 

  12. Khouri, Y.F. et al. Vertical transmission of HIV-1. Correlation with maternal viral load and plasma levels of CD4 binding site anti–gp120 antibodies. J. Clin. Invest. 95, 732–737 (1995).

    Article  CAS  Google Scholar 

  13. Weiser, B. et al. Quantitation of human immunodeficiency virus type 1 during pregnancy: Relationship of viral titer to mother-to-child transmission and stability of viral load. Proc. Natl. Acad. Sci. USA 91, 8037–8041 (1994).

    Article  CAS  Google Scholar 

  14. Fang, G. et al. Maternal plasma human immunodeficiency virus type 1 RNA level: A determinant and projected threshold for mother to child transmission. Proc. Natl. Acad. Sci. USA 92, 12100–12104 (1995).

    Article  CAS  Google Scholar 

  15. Sperling, R.S. et al. Maternal viral load, zidovudine treatment, and the risk of transmission of human immunodeficiency virus type 1 from mother to infant. Pediatric AIDS. Clinical Trials Group Protocol 076 Study Croup. N. Engl. J. Med. 335, 1621–1629 (1996).

    Article  CAS  Google Scholar 

  16. Saag, M.S. et al. HIV viral load markers in clinical practice. Nature Med. 2, 625–629 (1996).

    Article  CAS  Google Scholar 

  17. Ho, D.D., Mougdil, T. & Alam, M. Quantitation of human immunodeficiency virus type 1 in the blood of infected persons. N. Engl. J. Med. 321, 1621–1625 (1989).

    Article  CAS  Google Scholar 

  18. Krogstad, P.A. & Zack, J.A. Detection of viral DNA by PCR. in HIV Research Methods — A Practical Approach, (ed., Kara, J.) 143–150 (Oxford Univ. Press, Oxford, 1995).

    Google Scholar 

  19. Krogstad, P., Chen, I.S.Y., Canon, J. & Rey, O. Quantitative analysis of the endogenous reverse transcriptase reactions of HIV-1 variants with decreased susceptibility to azidothymidine and nevirapine. AIDS Res. Hum. Retroviruses 12, 977–983 (1996).

    Article  CAS  Google Scholar 

Download references

Author information

Author notes

  1. Yunzhen Cao and Paul Krogstad: These authors contributed equally to this work.

Authors and Affiliations

  1. Aaron Diamond AIDS Research Center, The Rockefeller University, 455 First Avenue, New York, New York, 10016, USA

    Yunzhen Cao, Richard A. Koup, Jia-Li Song & Zhanqun Jin

  2. Department of Pediatrics, UCLA School of Medicine, Los Angeles, California, 90024, USA

    Paul Krogstad

  3. Santa Fe Institute, Santa Fe, New Mexico, 87501

    Bette T. Korber

  4. Los Alamos National Laboratory, Los Alamos, New Mexico, 87545, USA

    Bette T. Korber

  5. Mathematics Department, University of Manchester Institute of Science and Technology, Manchester, M601QD, UK

    Mark Muldoon & Catherine Macken

  6. Departments of Medicine and Microbiology & Immunology, UCLA School of Medicine, Los Angeles, California, 90024, USA

    Jla-Qi Zhao & Irvin S.Y. Chen

  7. Pediatric AIDS Foundation, Santa Monica, California, 90405, USA

    Sheila Clapp & David D. Ho

  8. 104 Dominican Dr., San Rafael, California, 90401, USA

    Arthur J. Ammann

Authors
  1. Yunzhen Cao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paul Krogstad
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bette T. Korber
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Richard A. Koup
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mark Muldoon
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Catherine Macken
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jia-Li Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Zhanqun Jin
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jla-Qi Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Sheila Clapp
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Irvin S.Y. Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. David D. Ho
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Arthur J. Ammann
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cao, Y., Krogstad, P., Korber, B. et al. Maternal HIV-1 viral load and vertical transmission of infection: The Ariel Project for the prevention of HIV transmission from mother to infant. Nat Med 3, 549–552 (1997). https://doi.org/10.1038/nm0597-549

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nm0597-549

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing