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Sexual and Mother‐to‐Child Transmission of the Human Immunodeficiency Virus Type 1: A Review
Author(s) -
CHERMANN JEANCLAUDE
Publication year - 1998
Publication title -
american journal of reproductive immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.071
H-Index - 97
eISSN - 1600-0897
pISSN - 1046-7408
DOI - 10.1111/j.1600-0897.1998.tb00411.x
Subject(s) - transmission (telecommunications) , sexual transmission , pregnancy , virology , virus , sex organ , biology , sexual intercourse , fetus , trophoblast , immunology , human immunodeficiency virus (hiv) , cell , medicine , placenta , population , genetics , microbicide , environmental health , electrical engineering , engineering
PROBLEM: Sexual and mother‐to‐child transmission of the human immunodeficiency virus (HIV) type 1 occurs only with a low percentage of infection. Many instances of sexual intercourse result in no transmission, and only 20% of children are infected from seropositive mothers (3% in mothers treated with azidothymidine). METHOD OF STUDY: We analyzed the presence of HIV in various ejaculates of the same HIV‐infected patients, as well as in the cervico‐vaginal fluid. We have studied the mechanism of transmission from mother to child, by analyzing the cell‐to‐cell transmission in the trophoblast. RESULTS: Some ejaculates collected at different times from the same HIV‐infected males are free of virus, explaining the low rate of sexual transmission. We never found HIV in mobile spermatozoa. The trophoblast can be infected by HIV with a strain dependence and also transiently. By analyzing the tissue of the fetus, it was found that only some organs are infected, confirming the cell‐to‐cell transmission between the mother and child and not a true vertical transmission through the germinal lines. CONCLUSIONS: HIV is not always present in the genital secretion, explaining the low rate of sexual transmission. Mother‐to‐child transmission occurs during pregnancy but often after the second trimester and at delivery after cell‐to‐cell or blood transmission, respectively.