Pediatric AIDS: Maternal-Fetal and Maternal-Infant Transmission of Lentiviruses and Effects on Infant Development in Nonhuman Primates

Nonhuman primate models for human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) have been developed and refined in an effort to investigate key questions in lentiviral transmission and pathogenesis. Vertical transmission of HIV has been studied quite extensively in an effort to understand factors contributing to the timing and route of infection, which can be in utero, intrapartum, or postpartum via breastmilk. The large portion of vertical transmission occurs around the time of delivery, while earlier in utero transmission accounts for a smaller percentage. Lentivirus-infected nonhuman primates have been shown to exhibit behavioral and neurological pathology similar to HIV-infected humans, and they offer a means to examine the effects of lentivirus infection while controlling for confounding factors inherent in human populations. The nonhuman primate models have provided an opportunity to investigate developmental and neurological changes. This chapter analyzes the status of developmental disabilities in humans, the current status of nonhuman primate models for lentivirus infection, and how they have been utilized to study developmental disabilities, and potential treatments and vaccines designed to limit disease and its effects. A key issue in this field is the role of pathogenic effects that are attributed to genetic differences in the unique HIV isolates in each mother and child pair.