Revisiting the Role of Neutralizing Antibodies in Mother‐to‐Child Transmission of HIV‐1
1Université François Rabelais, Equipe Associée 3856, Centre National de Référence du VIH, Tours, and 2Institut de Recherche pour le Développement (IRD 054), Paris, France; 3Harvard School of Public Health, Boston, Massachusetts; 4Provincial Hospital, Rayong, 5Prachanukroh Provincial Hospital, Chiang Rai, 6Prapokklao Provincial Hospital, Chantaburi, and 7Provincial Hospital, Phayao, Thailand
We analyzed the association between mother‐to‐child transmission (MTCT) of human immunodeficiency virus type 1 (HIV‐1) and maternal neutralizing antibodies to heterologous primary isolates of various HIV‐1 clades, to test the hypothesis that protective antibodies are those with broad neutralizing activity. Our study sample included 90 Thai women for whom the timing of HIV‐1 transmission (in utero or intrapartum) was known. The statistical analysis included a conditional logistic‐regression model to control for both plasma viral load and duration of zidovudine prophylaxis. The higher the titer of neutralizing antibodies to a heterologous strain of the same clade, the lower the rate of MTCT of HIV‐1. More specifically, high levels of neutralizing antibodies to the MBA (CRF01_AE) strain were associated with low intrapartum transmission of HIV‐1. This suggested that such heterologous neutralizing antibodies may be involved in the natural prevention of late perinatal HIV transmission. These data are consistent with the hypothesis that the use of some antibodies might help to prevent perinatal HIV transmission, through passive immunoprophylaxis. Moreover, the study of humoral factors associated with MTCT of HIV‐1 may identify correlates of protection that should help in the design of efficient HIV/acquired immunodeficiency syndrome vaccines.
Received 24 October 2005; accepted 30 December 2005; electronically published 21 April 2006.
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Presented in part: AIDS Vaccine 04 Meeting, Lausanne, Switzerland, 30 August–1 September 2004 (abstract 44).
Potential conflicts of interest: none reported.
Financial support: Ensemble contre le Sida (Sidaction); Agence Nationale de Recherches sur le Sida; Institut de Recherche pour le Développement (IRD); National Institutes of Health (grant 5 R01 HD 33326).
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These authors are members of the Perinatal HIV Prevention Trial Group (IRD 054, Thailand).





