Ontogeny of anti-human immunodeficiency virus (HIV) antibody production in HIV-1-infected infants.

Abstract

The early serologic response of infants to infection with human immunodeficiency virus type 1 (HIV-1) is normally obscured by the presence of transplacentally acquired maternal HIV antibody. By measuring HIV antibody produced in vitro by lymphocytes isolated from peripheral blood of infants and children of HIV-1-infected mothers, we have been able to study the natural acquisition of humoral immunity to perinatal HIV-1 infection. One hundred ninety-seven infants of HIV-1-infected women were studied prospectively and longitudinally from birth. In the neonatal period, infected infants produced only small amounts of HIV-specific IgG antibodies to a restricted number of antigens. The amount of immunoglobulin to HIV-1 and the number of HIV-1 antigens recognized increased with age. After 6 months of life 85% of infected infants made detectable antibody to two or more viral proteins. Antibody to gp160 appeared first and was the most frequently found at all ages, followed by antibody to the envelope proteins gp120 and gp41. The amount of HIV antibody produced correlated positively with the percentage of CD4+ T lymphocytes in peripheral blood. This assay provides a method of studying the immunogenicity of vaccines against HIV-1 in HIV-1-infected infants and of assessing the effect of early therapeutic interventions on the humoral response to HIV-1.

Immediate zidovudine treatment protects simian immunodeficiency virus-infected newborn macaques against rapid onset of AIDS

“…This rapid disease progression and mortality is also seen in newborn macaques inoculated with SIV/Delta B670 (3), and the disease resembles that which is seen in a small percentage of SIV-inoculated adolescent and adult macaques that fail to mount a strong immune response (15). Persistent viremia and weak antiviral immune responses are also seen in perinatally infected children who show rapid disease progression (1,4,9,10,30,35,36).…”

“…However, starting AZT administration early in infection may produce greater beneficial effects than waiting until symptomatic disease becomes apparent, especially for infants, who may show rapid disease progression. Because the rapid development of AIDS in these infants is associated with high levels of viremia and weak antiviral immune responses (4,9,30,35), one would predict that AZT administration during the early stages of HIV infection may alter the natural history of infection by reducing the initial viremia which is responsible for early systemic dissemination.…”

Contrasting Adult and Infant Immune Responses to HIV Infection and Vaccination

“…As newborns are unlikely to have this pool of memory B cells, it is possible that the specificity of the early antibody response to HIV infection differs between adults and infants. Because the presence of maternally acquired antibodies clouds the investigation of infant antibody responses, Pollack et al (44) assessed the ability of lymphocytes isolated from 46 HIV-infected infants age 0 to 12 months to produce HIV-specific antibodies in vitro. Their results indicated that in the neonatal period, infants produced only low levels of antibodies against a restricted number of HIV antigens, but by 6 months of age, the majority of infants had detectable levels of antibodies against two or more HIV antigens.…”

Major histocompatibility complex class II DR alleles DRB1*1501 and those encoding HLA-DR13 are preferentially associated with a diminution in maternally transmitted human immunodeficiency virus 1 infection in different ethnic groups: determination by an automated sequence-based typing method.

“…has been to infectious virus with consequent elimination of the infection is unknown (6)(7)(8)(9)(10)(11)(12). Further to this point, a welldocumented instance of the apparent clearing of neonatal HIV infection has been reported (13).…”