Here’s how breakthrough research finds clues to eliminate HIV infection in infants:

It has long been a mystery why mother-to-baby transmission of HIV may or may not occur in the womb, but now the team of researchers at Weil Cornell Medicine and Duke University are doing the same. I found an important clue about. Tips for getting rid of infections in babies.

In a study published in the medical journal PLoS Pathogens, researchers found a rare virus in maternal blood that could escape mother-to-child transmission of HIV from a new type of treatment, a broadly neutralizing antibody (bnAbs). We have found evidence associated with the variant. It can be used to block various HIV strains. Scientists have also discovered that these HIV variants tend to contain important genetic features.

The findings provide a possible way to predict whether mother-to-child transmission of HIV will occur and provide a path to approaches that can help prevent such infections, the researchers said. ..

At the same time, the results show that treating HIV-positive pregnant women or new mothers with bnAb therapy may have the unintended effect of promoting the evolution of mutants that can resist these therapies and increasing the risk of mother-to-child transmission. Suggests.

“Our findings show that vaccines or treatments for pregnant and lactating women infected with HIV prevent the development of these resistant variants in order to reduce the likelihood of HIV transmission to children. It suggests that it should be designed for, “said senior author Dr. Sally Pelmer. Professor of Pediatrics and Nancy C. Paduano, Professor of Pediatrics at Weil Cornell and Chief of Pediatrics at the New York Presbyterian / Weil Cornell Medical Center.

Even if the mother is infected and untreated, the chances of getting the child are less than 50%, so the transmission of HIV from the mother to the newborn is puzzling.

Scientists assume that the factors that determine whether an infection occurs are in the mother’s immune system and / or HIV variants that circulate in the mother’s blood. However, it was difficult to focus on the causes of infection risk. In particular, antiretroviral (ART) medication, which is now standard for most HIV-infected individuals, is likely to confuse the findings of current patients.

Dr. Permar and her colleagues avoided this problem by evaluating a collection of samples from a study of HIV-infected mothers and their babies conducted 30 years before the age of ART.

In a series of experiments, Dr. Permar’s team isolated infant-infected HIV mutants from mothers, and these infected HIV mutants compared to uninfected mutants from the mother’s blood by about 30. Found to be%. Poor sensitivity to maternal plasma (antibody-containing fraction of maternal blood).

In other words, the difference between infected and non-infected was believed, at least in part, to changes in HIV that allowed the mother to escape from the antibody.

Detecting a mother’s HIV escape variant has never been easier. Researchers have observed that HIV variants in infected mothers and HIV variants in uninfected mothers as a whole are equally sensitive to maternal plasma. Finally, the researchers analyzed the sequence of HIV mutants in infected and uninfected mothers. Some genetic features were associated with infectious and non-infectious.

Most of these signatures were also associated with the rare feature of avoiding neutralization by some or all of the bnAbs panels. The latter is an antibody originally isolated from a small number of HIV-positive individuals, known to block a wide variety of HIV strains, and has been developed as an HIV therapy.

“This finding suggests that the presence of widely neutralizing antibody-escape variants in the blood of HIV-infected mothers is a predictor of a higher risk of transmission to newborns,” said Dr. Palmer. Said.

This is because vaccines or treatments given to HIV-infected pregnant or lactating mothers as an aid to ART to reduce the risk of infection are effective against HIV variants that can escape these special antibodies. Indicates that it needs to be targeted. If the presence of strong antibodies facilitates the evolution of HIV into resistant mutants, vaccination of the mother to induce broadly neutralizing antibodies or delivery of a therapeutic bnAb mixture may result in mother-to-child. Infection may increase.

Dr. Palmer and his colleagues are currently working to better understand how to deal with this issue.

An approach worth investigating includes giving pregnant HIV-infected women high-dose short-term combination bnAb therapy containing multiple types of these antibodies to minimize the risk of escape. Dr. Palmer said. We also provide multi-bnAb therapy directly to babies at birth in the hope of treating HIV infections that occur during childbirth and preventing subsequent HIV infections from breastfeeding.

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