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

A new study has found a new type of treatment that can be used to block a wide variety of HIV strains in the mother’s blood and help prevent HIV infection in infants.

Here’s How Breakthrough Research Finds Clues to Eliminate HIV Infections in Infants (Shutterstock)

Why the transmission of an HIV infection from mother to baby in the womb occurs in some cases but not in others has long been a mystery, but now a team of researchers from Weill Cornell Medicine and Duke University has found an important clue as to the same that also gives treatment.

tips to eliminate the infection in infants. In a study published in the medical journal PLoS Pathogens, the researchers found evidence that mother-to-child transmission of HIV is associated with rare variants of the virus in the mother’s blood that can escape broadly neutralizing antibodies (B Abs) , an emerging type of treatment.

that can be used to block a wide variety of HIV strains. The scientists also found that these HIV variants tend to contain important genetic signatures. The findings provide a possible way to predict whether mother-to-child transmission of HIV will occur and point the way to approaches that could help prevent such transmission, the researchers said.

At the same time, the results indicate that treating HIV-positive pregnant women or new mothers with Baby therapies could have the unintended effect of promoting the evolution of variants that can resist these therapies, reducing the risk of mother-to-child transmission. increases.

Our findings suggest that vaccines or treatments for HIV-infected pregnant and breastfeeding women should be designed to prevent the development of these resistant variants in order to reduce the risk of HIV transmission to the child, ” said senior author Dr. Sallie Permar, president of pediatrics and Nancy C. Padua No professor of pediatrics at Weill Cornell Medicine and chief pediatrician at New York-Presbyterian / Weill Cornell Medical Center.

Mother-to-newborn transmission of HIV is a mystery because even if the mother is infected and untreated, the chance of transmission to the child is less than 50 percent.

Scientists have hypothesized that the factors that determine whether transmission occurs are due to the mother’s immune system and / or the HIV variants circulating in her blood.

But identifying the source of the transmission risk has been challenging, not least because antiterrorism (ART) drug therapy, which is now standard for most HIV-infected individuals, likely reflects the results of each study of current patients. would confuse.

Dr. Permar and her colleagues got around this problem by evaluating a collection of samples from a study of HIV-infected mothers and their babies conducted three decades ago, before the age of ART.

In one series of experiments, Dr. Permar’s team isolated the HIV variants that had been passed on from the mothers to their babies and found that these transmitted HIV variants – compared to non-communicable variants from the mother’s blood – were about 30 percent .

less sensitive to maternal plasma – the antibody-containing fraction of maternal blood. In other words, the difference between transmission and non-transmission appeared to be at least in part due to HIV variations escaping maternal antibodies. Detecting those HIV escape variants in the mothers was not easy.

The researchers noted that HIV variants in transferring mothers and HIV variants in non-transferring mothers were generally just as sensitive to maternal plasma.

Ultimately, the researchers analyzed genetic sequences in the HIV variants of transmitting and non-transmitting mothers and found that different genetic signatures were associated with transmission versus non-transmission.

Most of these signatures were also related to the rare ability to escape neutralization by some or all of the B Abs panel. The latter are antibodies originally isolated from a few HIV positive individuals, which are known to block a wide variety of HIV strains and are being developed as HIV therapies.

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

This, in turn, indicates that any vaccine or treatment given to HIV-infected pregnant or nursing mothers, in addition to ART to reduce the risk of transmission, must be effective against HIV variants that can contain these special antibodies. escape. vaccinating mothers to raise broadly neutralizing antibodies, or delivering mixtures of therapeutic B Abs, can in some cases lead to increased mother-to-child transmission – if the presence of the potent antibodies promotes the evolution of HIV into resistant variants.

Dr. Permar and his colleagues are now working to better understand how this problem can be addressed. Approaches worth exploring, Dr. Permar said, include giving a high-dose, short-term combination of Baby therapy with multiple types of these antibodies to minimize the risk of escape;

and also administering multi-Baby therapy directly to infants at birth in the hope of curing any HIV infection that occurs during labor and preventing subsequent HIV infection through breastfeeding.