The vertical transmission of human immunodeficiency virus type 1: Molecular and biological properties of the virus

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33 Scopus citations


The vertical (mother-to-infant) transmission of human immunodeficiency virus type 1 (HIV-1) occurs at an estimated rate of more than 30 % and is the major cause of AIDS in children. Numerous maternal parameters, including advanced clinical stages, low CD4+ lymphocyte counts, high viral load, immune response, and disease progression have been implicated in an increased risk of vertical transmission. While the use of antiretroviral therapy (ART) during pregnancy has been shown to reduce the risk of vertical transmission, selective transmission of ART-resistant mutants has also been documented. Elucidation of the molecular mechanisms of vertical transmission might provide relevant information for the development of effective strategies for prevention and treatment. By using HIV-1 infected mother-infant pairs as a transmitter- recipient model, the minor genotypes of HIV-1 with macrophage-tropic and non-syncytium-inducing phenotypes (R5 viruses) in infected mothers were found to be transmitted to their infants and were initially maintained in the infants with the same properties. In addition, the transmission of major and multiple genotypes has been suggested. Furthermore, HIV-1 sequences found in non-transmitting mothers (mothers who failed to transmit HIV-1 to their infants in the absence of ART) were less heterogeneous than those from transmitting mothers, suggesting that viral heterogeneity may play an important role in vertical transmission. In the analysis of other regions of the HIV-1 genome, we have shown a high conservation of intact and functional gag p17, vif, vpr, vpu, tat, and nef open reading frames following mother-to-infant transmission. Moreover, the accessory genes, vif and vpr, were less functionally conserved in the isolates of non-transmitting mothers than transmitting mothers and their infants. We, therefore, should target the properties of transmitted viruses to develop new and more effective strategies for the prevention and treatment of HIV-1 infection.

Original languageEnglish (US)
Pages (from-to)1-34
Number of pages34
JournalCritical reviews in clinical laboratory sciences
Issue number1
StatePublished - Jan 2005


  • AIDS
  • Antiretroviral therapy
  • HIV-1
  • HIV-1 genes
  • HIV-1 genotypes and phenotypes
  • Vertical transmission
  • Viral and host factors

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Clinical Biochemistry
  • Biochemistry, medical


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