Summaries of Presentations at the 32nd Interscience Conference on Antimicrobial Agents and Chemotherapy

Tuesday, October 13, 1992

8:45 A.M. P.T. (11:45 A.M. E.T.)
Measuring HIV Infection Status of Pregnant Women Helps Predict Baby's Infection #599 Oral
Measurements of a pregnant woman's HIV infection and CD4+ T white blood cells are associated with
the likelihood that she will transmit the infection to her child.
In an ongoing study, scientists examined a group of 181 children born to mothers in the Womens and
Infants Transmission Study (WITS), supported by NIAID and NICHD. By testing for the presence of
HIV in the blood of women during pregnancy, they found women who always had positive cultures
had more than twice the rate of infected babies than those mothers whose cultures sometimes or
always were negative, (29 percent versus 12 percent).
In an analysis of only those women who did not take zidovudine (AZT), the investigators found that
of women with more than 28 percent CD4+ T cells in their blood, 13 percent had culture positive
babies, while mothers with CD4+ T cells of 14 to 28 percent had 33 percent positive babies and those
with less than 14 percent CD4+ T cells had 38 percent positive babies.
"Prenatal Maternal Circulating Leukocyte HIV Predisposes to HIV Culture Positivity in Their Infants:
Progress report from a North American Cohort," Jane Pitt, M.D., Columbia Presbyterian Medical
Center, New York, N.Y.; Alan Landay, M.D., Rush-Presbyterian-St. Luke's Medical Center, Chicago,
Ill.; Kenneth McIntosh, M.D., Children's Hospital, Boston, Mass.; George Hillyer, M.D., University of
Puerto Rico, San Juan; Donald Brambilla, Ph.D., New England Research Institute, Inc., Watertown,
Mass.; David Burns, M.D., M.P.H., National Institute for Child Health and Human Development,
Bethesda, Md.; Mary Glenn Fowler, M.D, M.P.H., NIAID, Bethesda, Md.; and Hermann Mendez,
M.D., State University of New York, Brooklyn, for the Womens and Infants Transmission Study
(WITS), supported by NIAID and the NICHD.
9:15 A.M. P.T. (12:15 P.M. E.T.)
Inflammation of Placenta Strongly Associated with HIV Transmission #601 Oral
Inflammation of the placenta is strongly associated with risk of transmitting HIV infection to an
unborn child, independent of the mother's immune system status. Therefore, investigators conclude,
placental inflammation may be a marker for a distinct biological mechanism for such transmission,
providing a possible approach for prevention.
For the study, investigators followed 324 pregnant, HIV-infected women in Kinshasa, Zaire. They
found that inflammation of the placenta significantly increased the risk of HIV transmission, with the
strongest association occurring in women with counts of the CD4+ T helper lymphocytes, a type of
white blood cell, of more than 20 percent of the total number of lymphocytes than for those with
lower percentages.

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