Conference Summary [Conference on Global Strategies for the Prevention of HIV Transmission from Mothers to Infants (1997)]

Viral and Immunologic Aspects of Perinatal HIV Transmission
* The reduction in viral load explains only part of the reduction in risk of
transmission. In fact, some research suggests it may not even be necessary
to reduce viral load in order to reduce the risk of transmission.
* A combination of an active/passive vaccine may be the most effective
approach. A vaccine should be developed from the viral strains in the
community.
* A combination, or "cocktail", of antibodies may have a chance of controlling
the virus and reducing risk of transmission in the developing world.
* It remains unclear why some individuals who are repeatedly and frequently
exposed to HIV do not become infected. While in the U.S. partial protection
against HIV infection is associated with absence of a chemokine receptor
found primarily in Caucasians, this association has not been seen in blacks.
Researchers are studying whether these responses represent protective
immunity. Do these individuals have a cellular or humoral response that
protects them? If so, is there a way to replicate the response in a vaccine?
* Scientists do not know the exact role of antibodies in the prevention and
treatment of HIV. Because there is some precedent for using antibodies to
treat or prevent virus, as with polio, there is hope immunotherapy could play a
role with HIV.
* NIH is now running three vaccine clinical trials, with a total of more than 2,000
uninfected volunteers. A vaccine offers the only hope for the ultimate control
of the HIV epidemic.

7