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October 23, 1996

Perinatal Transmission of HIV-1

Author Affiliations

Yokohama City University School of Medicine Yokohama, Japan

JAMA. 1996;276(16):1300. doi:10.1001/jama.1996.03540160022021

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.