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October 23, 1996

Perinatal Transmission of HIV-1-Reply

Author Affiliations

UCLA School of Medicine Los Angeles, Calif

JAMA. 1996;276(16):1301. doi:10.1001/jama.1996.03540160023023

In Reply.  —Dr Asakura and colleagues correctly point out the potential importance of the role of HIV phenotype as manifested by macrophage tropism in perinatal transmission. Several studies have suggested that macrophage-tropic, non— syncytial-inducing HIV virus isolates are more likely to be transmitted.1,2 In a subset of the patients in our cohort, we also observed that non—syncytial-inducing HIV isolates were preferentially transmitted even in women who harbored syncytial-inducing HIV strains. In one case of syncytial-inducing virus transmission in our study, both the mother and infant had rapid progression to the acquired immunodeficiency syndrome (AIDS). Husson et al3 have reported a similar phenomenon. The reasons for preferential transmission of non— syncytial-inducing strains in perinatal, parenteral, and sexual transmission are not clear, but are the subject of intense research. Our study addressed the question of the quantity (not the quality) of virus present in maternal blood and showed that the level of