To the Editor.
—Dr Dickover and colleagues1 clearly demonstrated that high maternal plasma human immunodeficiency virus (HIV)—1 RNA levels correlate with perinatal transmission, and zidovudine treatment decreases risks of maternal-to-fetus transmission through reduction of HIV-1 viral load estimated by maternal plasma RNA levels.However, although the authors cited information about the influence of viral phenotype in HIV-1 infection,2,3 recent reports have revealed the importance of monocyte-macrophage— tropic HIV-1 isolates for establishing infections.4,5 Thus, their conclusion, without a consideration of maternal and fetal viral phenotypes on the risks of vertical transmission, is rather dangerous; these viral tropisms should be investigated and discussed at the same time.
Asakura Y, Mohri H, Okuda K. Perinatal Transmission of HIV-1. JAMA. 1996;276(16):1300. doi:10.1001/jama.1996.03540160022021