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Newborn Factors in Maternal-Infant Transmission of Pediatric HIV Infection¹

UCLA Department of Pediatrics, Los Angeles, CA 90095

Factors affecting maternal-infant transmission (MIT) can be conveniently divided into 5 categories: (1) maternal factors (e.g. maternal immunologic status, anti-retroviral treatment), (2) virologic factors (e.g. viral load, strain, tissue tropism and resistance), (3) obstetric factors (e.g. traumatic delivery, chorioamnionitis, C-section), (4) fetal factors (e.g. prematurity, coinfection, twinning) and (5) infant factors (e.g. immune status, drugs, nutrition). Several of these factors (e.g., prematurity, maternal medication) can be classified as both maternal and fetal, and some factors (e.g. nutrition) include both fetal and neonatal period. This review focuses on the following six fetal/infant factors: (1) timing of transmission, (2) prematurity, (3) fetal and neonatal nutrition, (4) neonatal GI function, (5) breastfeeding, and (6) the maturity of infant's immune system. Ways in which these factors may influence both the rate of MIT and the progression of the disease in the infant are discussed.

KEY WORDS: • HIV infection • transmission • drugs • nutrition • prematurity • breastfeeding

¹ Presented at the workshop entitled "Nutrition in Pediatric HIV Infection: Setting the Research Agenda" held in Bethesda, MD on September 28–29, 1995. The workshop was sponsored by the Office of AIDS Research of the National Institutes of Health, the National Institute of Child Health and Human Development, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Allergy and Infectious Diseases, National Institute of Mental Health, Food and Drug Administration, Pediatric AIDS Foundation, National Dairy Council, Sandoz Nutrition Corporation, Bristol-Meyers Squibb Company, Clintec Nutrition Company, Ross Products Division-Abbott Laboratories, Serono Laboratories, Inc., and the American Institute of Nutrition. Workshop proceedings are published as a supplement to The Journal of Nutrition. Guest Editors for this supplement publication were Daniel J. Raiten and John M. Talbot, Life Sciences Research Office, Federation of American Societies for Experimental Biology, Bethesda, MD.

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