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HISTORICAL ESSAY:
Enhanced: Prospects for the Future

Robert C. Gallo and Luc Montagnier*

With close to 70 million people already infected with HIV and more than 20 million dead, AIDS is one of the greatest pandemics in medical history. [HN1] Not only is this a human tragedy of unimaginable dimensions, it is also a threat to world security because of the potential for political destabilization. The AIDS epidemic must be halted soon. We need a policy of prevention that can be adapted to the sociological and cultural conditions of the most devastated countries in Africa and Asia [HN2], and that encompasses sustained international political will. New developments in AIDS research will contribute decisively to the decline of the epidemic and eventually its eradication. From the beginning of the epidemic, science has produced the most important practical advances: from discovering the cause of AIDS to developing a blood test and anti-HIV drugs. Now, science must develop new therapies that are practical alternatives for the developing world, as well as new microbicidals that block sexual transmission, until an efficacious vaccine arrives.

In developed nations, the judicious use of combination anti-HIV drug therapy [HN3] has substantially benefited HIV-infected people and has ended the pediatric epidemic. The Global Fund to Fight AIDS, Malaria and Tuberculosis [HN4]--launched by Koffi Annan, the secretary-general of the United Nations--is spearheading efforts to translate these advances worldwide. However, the challenge is huge and has been complicated by many factors, including the emergence of multidrug-resistant HIV mutants. [HN5] New antivirals that target not only dividing cells but also "resting" cells, and strategies that augment intracellular levels of active drug through modulation of metabolic pathways, may improve the suitability of existing drugs (1, 2). New classes of drugs, particularly HIV entry inhibitors, show promise. [HN6] They have the advantage of stopping HIV before it establishes new infections in host cells. Preliminary studies show impressive results with inhibitors that block each stage of HIV entry: attachment and binding to CD4+ T cells [HN7], coreceptor binding, and fusion of the viral and cellular membranes (3, 4).

What can be done to bring anti-HIV therapy to developing countries with limited infrastructure? Administering these therapies is complex, and patient compliance is a major challenge. If compliance and careful follow-up of patients is not achieved, we will see a dramatic increase in multidrug-resistant HIV mutants whose further spread will only exacerbate the epidemic. With our 20 years of experience, we propose the following priorities for eliminating AIDS worldwide.

Access to Antiretroviral Treatments
One of the main objectives of the Global Fund to Fight AIDS is to make anti-HIV drugs accessible to all of the developing world. The problem of cost can be partly solved by reducing drug prices (through lower pricing acceptable to pharmaceutical companies, use of generic drugs, and financial help from the Global Fund). But the infrastructure necessary for performing follow-up of patients during treatment will be costly and difficult, and the duration of such treatments will make them ultimately unaffordable for patients in poor countries. This is an unprecedented situation. The decrease in plasma viral load achieved with triple drug therapy does not stabilize after treatment interruption, which results in a rapid increase in circulating virus. Moreover, there are severe limitations to antiretroviral therapy, including toxic side effects (lipid deposition, increased risk of diabetes and cardiac infarcts, muscular and neurological toxicity). Therefore, it is imperative to launch clinical trials to test additional treatments that are less toxic and less expensive.

Therapies for the Developing World
After 6 months of continuous antiretroviral therapy, a patient's immune system is usually partly restored, and it is then possible to mount a relatively potent immune response against HIV. We suggest that patients on drug therapy for 6 months might benefit from being vaccinated at this stage. The efficacy of vaccination could be rapidly assessed by comparing the intensity of viral rebound in unvaccinated versus vaccinated patients after cessation of drug therapy.

Vaccines and Microbicidal Agents
Developing a vaccine [HN8] is, of course, the ideal way to contain and even eradicate the AIDS epidemic, but there are serious difficulties:

· It is impossible to use a "live" attenuated retroviral vaccine in humans, for safety reasons.

· Experimental data are disappointing, and there are hazards with "killed" whole-virus vaccines.

· There is extreme variability in the dominant epitopes of the HIV surface glycoprotein.

· A vaccine needs to stimulate both systemic and mucosal immunity [HN9].

· It is difficult to run Phase III trials involving thousands of volunteers who are already highly exposed to HIV.

· HIV's capacity to integrate its genetic information into the DNA of target cells quickly establishes infection. This means that a vaccine response must be quick and effective in preventing HIV entry (by inducing production of neutralizing antibodies) and potent in finding and killing infected cells (by inducing activation of killer T cells).

AIDS vaccines are based on HIV subunits--that is, on one or more HIV proteins or portions of such proteins that are delivered directly or in the form of DNA that is then expressed in the target tissue. First attempts at developing a vaccine from 1984 to about 1990 used unmodified forms of the HIV protein envelope gp120. The goal was to induce neutralizing antibodies that could block virus entry and thereby possibly achieve complete protection from infection. But this approach failed in monkey tests (and may fail in humans) because the neutralizing antibodies are often short-lived and unable to block infection by a broad range of HIV strains. Consequently, in the 1990s the emphasis switched to inducing T cell-mediated immunity, involving production of killer T cells [HN10]. Trials in monkeys infected with SIV or SHIV did not produce complete protection but kept virus at levels too low to cause disease for more than 1 year, creating optimism for trials (now ongoing) in humans (5). There are two arguments in favor of this approach. First, successful vaccines do not necessarily have to achieve complete protection; for example, in vaccinated individuals exposed to poliovirus, the virus replicates in the gut before the recall immune response targets the virus. Second, some argue that with AIDS there is no other choice because we cannot achieve broadly reactive, long-lasting neutralizing antibodies. However, we point out that poliovirus is ultimately eliminated after vaccination, whereas HIV is a retrovirus [HN11] that integrates its genes into target cell DNA such that cells may express the virus at variable levels after vaccination. In addition, there have been some reports of broadly reactive neutralizing antibodies raised against primary isolates of HIV (6) and of new candidate vaccines that achieve this goal (7) [HN12]. However, adequate levels of the immune response would need to be maintained by boosting (which exposure to HIV might achieve).

To quickly evaluate the efficacy of immunization, we propose that candidate subunit vaccines be tested in HIV-infected persons as therapeutic supplements after initial antiretroviral therapy. The endpoint--a lack of viral rebound after interruption of drug therapy--should be easy to measure. From such therapeutic trials the best subunit combination could then be selected for testing in a full-scale clinical trial. There have been encouraging data with candidate microbicidal agents such as the cyclodextrins [HN13], which block infection when delivered at portals of entry (8).

Blocking Mother-to-Infant Transmission
In developed countries, mother-to-infant transmission [HN14] has been blocked by several approaches: blood testing of mothers and, if they are positive, advising them to avoid breastfeeding; caesarian delivery when intrapartum risks are great; reducing HIV levels in mothers by treating them with triple drug therapy throughout pregnancy; and postpartum prophylactic treatment of the exposed newborn for its first week of life. In Africa, a single dose of a reverse transcriptase inhibitor given to mothers and their newborns decreased transmission from approximately 30% to 10% (9). However, postpartum infection continues to be a major problem in developing nations because of HIV transmission through breast-feeding. We are collaborating with colleagues in Rome on a program called "Families First Africa." In sites in West Africa, we plan to administer prophylactic antiretroviral therapy to pregnant mothers and to vaccinate their newborns with HIV peptides matching their HLA genotype; we will take advantage of the BCG vaccination routinely given to newborns in these countries by adding the HIV peptides to the BCG vaccine, which acts as a strong adjuvant. This approach will primarily induce cellular immunity without excluding an antibody response.

Prevention, Treatment, and Research
Scientists and clinicians in developed countries must contribute to the creation of infrastructure in the countries worst hit by AIDS. They need to train health care specialists in these countries, help to conduct clinical trials, and set up laboratories to analyze viral strains. There needs to be a transfer of technology from the North to the South and a two-way exchange of information. A center was created in 1996 in Abidjan by the World Foundation for AIDS Research and Prevention under the aegis of the government of Côte d'Ivoire and UNESCO [HN15] for this purpose. The center integrates three activities under one roof: prevention by education (training of industry and administrative managers), treatment of ambulatory patients (within the UNAIDS initiative program), and laboratory and clinical research (in preparation for clinical trials). The Institute of Human Virology has also established programs in Africa and the Caribbean with similar goals. We suggest that each country create and develop a reference center integrating these three activities, with the possibility of radiating to rural regions through satellite mobile units. This will require close interactions between local governments, United Nations international agencies, and nongovernmental organizations. There needs to be a strong political will on the part of the governments of developing nations and generous financial contributions from the developed world, conveyed through a United Nations organization, such as WHO or UNESCO, in coordination with UNAIDS. It is also important that developing countries themselves participate financially. We suggest that the amount of funding from developing countries for AIDS projects should be deducted from their national debts to developed countries. More than ever, a global coordinated response is required to fight the scourge of AIDS.

References

  1. C. Davis et al., J. Hum. Virol. 4, 113 (2001). [Medline]
  2. A. Heredia et al., J. Acquir. Immune Defic. Syndr. 25, 246 (2000). [Medline]
  3. C. C. LaBranche et al., Antivir. Res. 50, 95 (2001). [Medline]
  4. A. Palani et al., J. Med. Chem. 45, 3143 (2002). [Medline]
  5. D. H. Barouch et al., Nature 415, 335 (2002). [Medline]
  6. J. P. Moore, D. R. Burton, Nature Med. 5, 142 (1999). [Medline]
  7. T. Fouts et al., Proc. Natl. Acad. Sci. U.S.A. 99, 11842 (2002). [Medline]
  8. K. V. Khanna et al., J. Clin. Invest. 109, 205 (2002). [Medline]
  9. L. A. Guay et al., Lancet 354, 795 (1999). [Medline]

R. C. Gallo is at the Institute of Human Virology and Department of Microbiology and Immunology, University of Maryland, Baltimore, MD 21201, USA. L. Montagnier is President of the World Foundation for AIDS Research and Prevention, 1 rue Miollis, Paris F-75015, France.


HyperNotes
Related Resources on the World Wide Web

General Hypernotes

This issue of Science (which coincides with World AIDS Day 2002) also features historical essays about AIDS/HIV on pages 1726 ("Discovering the cause of AIDS" by S. B. Prusiner), 1727 ("A history of HIV discovery" by L. Montagnier), and 1728 ("The early years of HIV/AIDS" by R. Gallo). A collection of contemporary Science news articles is provided as a Science Online feature.

Dictionaries and Glossaries


The xrefer Web site provides searchable scientific dictionaries and other reference works.

The On-line Medical Dictionary is provided by CancerWeb.

The Glossary of HIV/AIDS-Related Terms is provided by the HIV/AIDS Treatment Information Service.

An HIV glossary is provided by The Body, an AIDS and HIV information resource.

Web Collections, References, and Resource Lists


Yahoo provides HIV/AIDS Internet links and news coverage related to AIDS.

D. Sander's All the Virology on the WWW includes a section on AIDS information and research.

The library of the Karolinska Institutet, Stockholm, Sweden, provides links to Internet biomedical resources with a section on viral diseases.

MEDLINEplus from the National Library of Medicine (NLM) provides links to AIDS Internet resources. NLM's Specialized Information Services Division also provides a collection of Internet resources on AIDS as well as a guide to HIV/AIDS information services of the National Institutes of Health (NIH).

U.S. government AIDS resources include those offered by the NIH Office of AIDS Research, the Division of Acquired Immunodeficiency Syndrome (AIDS) of the NIH's National Institute of Allergy and Infectious Diseases (NIAID), the National Center for HIV, STD and TB Prevention of the Centers for Disease Control and Prevention (CDC), the AIDS Clinical Trials Information Service, and the HIV/AIDS Treatment Information Service.

International resources include those of the CDC's Global AIDS Program, UNAIDS (the United Nations Programme on HIV/AIDS), the World Health Organization (WHO), the WHO Department of HIV/AIDS, the United Nations Development Programme, the World Bank, and the Pan American Health Organization.

The International AIDS Economic Network, AVERT, Family Health International, and the International AIDS Society are other resources for global AIDS information.

Other resources focusing on AIDS research, prevention and treatment, and news include the American Foundation for AIDS Research, the JAMA HIV/AIDS Resource Center, the Johns Hopkins AIDS Service, the Harvard AIDS Institute, the AIDS Education Global Information System, AIDS.org, HIV InSite, The Body, and the Kaiser Family Foundation.

AIDScience from Science Online is a resource for information on prevention and vaccine research. Included are recent Science Classic Papers and the Cohen File (Science news articles about HIV/AIDS by J. Cohen).

Online Texts and Lecture Notes


Cells Alive offers an animated presentation on HIV infection.

The immunology section of the University of Arizona's Biology Project offers an HIV and AIDS tutorial.

The HIV InSite Knowledge Base is on online textbook on HIV disease.

J. Kimball maintains Kimball's Biology Pages, an online biology textbook and glossary. A presentation on AIDS is included.

The Bookshelf provided by the National Center for Biotechnology Information (NCBI) makes available the fifth edition of Immunobiology by C. Janeway, P. Travers, M. Walport, and M. Shlomchik.

Microbiology and Immunology On-line is a Web textbook provided by the Department of Pathology and Microbiology, University of South Carolina School of Medicine. The virology section includes a chapter on HIV.

The Department of Microbiology and Immunology, University of Rochester Medical Center, offers lecture notes and resources in virology. Included are lecture notes on the pathogenesis and molecular biology of HIV-1, as well as an introduction to AIDS/HIV for high school students

The Department of Microbiology and Immunology, University of Leicester, UK, makes available lecture notes for a course on virology. Lecture notes on retroviruses and the pathogenesis of AIDS are included.

P. Bugl, Department of Mathematics, University of Hartford, CT, provides lecture notes and links to related readings for a course on epidemics and AIDS.

C. Toebe, Department of Biology, City College of San Francisco, provides lecture notes for a course on the biology of AIDS.

M. Hewlett, Department of Molecular and Cellular Biology, University of Arizona, provides lecture notes for a virology course.

General Reports and Articles


In Their Own Words...NIH Researchers Recall the Early Years of AIDS is presented by NIH.

The November-December 2002 issue of Foreign Affairs had an article by N. Eberstadt titled "The future of AIDS."

The September 2002 issue of the Population Bulletin, published by the Population Reference Bureau, had an article (available in PDF format) by P. Lamptey, M. Wigley, D. Carr, and Y. Collymore "Facing the HIV AIDS pandemic."

The Hopkins HIV Report provides coverage of the XIV International AIDS Conference in Barcelona including an article by T. C. Quinn titled "The global HIV/AIDS pandemic 2002: A status report" and an article by J. Nachega titled "Antiretroviral treatment in developing countries."

The 28 June 2002 issue of Science had a special report titled "HIV/AIDS: Therapies, Vaccines, Challenges." Included were a New Focus article about therapies titled "Confronting the limits of success" and a News Focus article about vaccines titled "Monkey Puzzles," both by J. Cohen.

The June 2002 issue of Scientific American had an article by C. Ezzell titled "Hope in a vial: Will there be an AIDS vaccine anytime soon?" The November 2001 issue had an article about antiviral drugs by W. A. Haseltine title "Beyond chicken soup."

Vaccines for the 21st Century: A Tool for Decisionmaking is a 2001 report available from the National Academies Press.

The Jordan Report 20th Anniversary: Accelerated Development of Vaccines 2002 is made available by NIAID in PDF format. A section on HIV vaccines is included.

Numbered Hypernotes

  1. The AIDS pandemic. NIAID provides a September 2002 fact sheet of HIV/AIDS statistics for the U.S. and the world. Report on the Global AIDS Epidemic 2002 is provided by UNAIDS, which also makes available epidemiological fact sheets on HIV/AIDS by country. A five-part series on AIDS at 20 is provided by the Kaiser Daily HIV/AIDS Report. The 1997 World Bank report Confronting AIDS: Public Priorities in a Global Epidemic and other resources are made available by the World Bank AIDS Economics Web site. BBC News presents AIDS Up Close, a collection of articles and background material on AIDS, and a 2001 report AIDS around the world, as well as a 2 July 2002 article titled "AIDS epidemic 'still in early stages'" and an 8 July 2002 article by J. Buchan titled "The changing face of AIDS."

  2. AIDS in Africa and Asia. The HIV/AIDS Surveillance Web site of the U.S. Census Bureau provides AIDS profiles of developing countries. AVERT offers an information page about the global AIDS epidemic with reports on AIDS in Asia and Africa. Tracking the Global Epidemic from the American Foundation for AIDS Research provides regional reports on Africa, Asia, Latin America, and other regions. BBC News provides a special report on AIDS in Africa; also available are a 14 October 2000 article titled "South-east Asia 'facing AIDS crisis,'" a 28 November 2001 article titled "Africa devastated by AIDS," and a 19 November 2002 article titled "Huge cost of AIDS to Uganda." The Washington Post makes available a special report titled "Death wish: AIDS, drugs, and Africa."

  3. Combination anti-HIV drug therapy. The U.S. Food and Drug Administration (FDA) provides a list of approved drugs for HIV/AIDS and AIDS-related conditions. The June-August 1999 issue of FDA Consumer had an article by J. Henkel titled "Attacking AIDS with a 'cocktail' therapy drug combo sends deaths plummeting." NIAID provides a fact sheet about HIV infection treatment. BBC News provides a background briefing on AIDS drugs. The AIDS Treatment Data Network provides a fact sheet on combination anti-HIV therapy. The Treatment Guidelines Library of the HIV/AIDS Treatment Information Service makes available (in PDF format) guidelines for the use of antiretroviral agents in HIV-Infected adults and adolescents. The Pan American Health Organization provides a resource page on antiretroviral treatment. The World Bank AIDS Economics Web site offers a special focus area on antiretroviral treatment in developing countries.

  4. The Global Fund to Fight AIDS, Tuberculosis & Malaria is an independent, public-private partnership, established in January 2002.

  5. HIV drug resistance. Roche-HIV.com offers a presentation on HIV drug resistance. The American Foundation for AIDS Research makes available a February 2002 article by A. d'Adesky titled "Studies warn of global drug resistance" and other resources on drug resistance. The 13 February 2002 issue of JAMA had a meeting report by J. Stephenson titled "'Sobering' levels of drug-resistant HIV found." The HIV InSite Knowledge Base provides information about drug resistance in HIV in a chapter by R. Shafer titled "Genotypic testing for HIV drug resistance." The Winter-Spring 2001 issue of the Harvard AIDS Review had an article by M. Holme titled "The challenge of HIV drug resistance." HIVresistanceWeb makes available a 27 September 2002 review by R. Kantor and D. Katzenstein titled "Antiretroviral drug resistance in non-subtype B HIV-1 isolates from treated patients" and a presentation by R. Shafer titled "How we know what we know about HIV drug resistance."

  6. New anti-HIV drugs. AIDS.org offers a series of fact sheets about new drugs against HIV: reverse transcriptase inhibitors, protease inhibitors, and immune stimulators. BBC News provides a 7 July 2002 article titled "AIDS: The medical progress" and an 8 July 2002 article titled "HIV: The drug firms' quest for a cure." The Pharmaceutical Research and Manufacturers Association offers (in PDF format) a 2001 report about new medicines in development for AIDS and other resources on new AIDS drugs in development. The Body offers links to information on fusion (entry) inhibitors and other new AIDS drugs. The Bulletin of Experimental Treatments for AIDS, published by the San Francisco AIDS Foundation, had an August 2002 article by N. Cheonis titled "The HIV/AIDS drug pipeline: A status report."

  7. CD4+ T cells. T cell (T lymphocyte) and CD (cluster of differentiation) are defined xrefer's Dictionary of Biology. The Immunology Book Case, a tutorial provided by the Department of Microbiology and Immunology, Dalhousie University School of Medicine, offers an introduction to T cells. NIAID offers an introduction to the immune system with a section on T cells. The Immunology Division, Department of Pathology, University of Cambridge, UK, makes available lecture notes on T cells for an immunology course. Kimball's Biology Pages provides an introduction tot CD4+ T cells. The Department of Microbiology and Immunology, University of Leicester, makes available lecture notes on CD4+ T helper cells and on antiviral immunity. The JAMA HIV/AIDS Information Center offers a background briefing on the CD4 molecule.

  8. AIDS Vaccines. Search for a vaccine is a presentation on NOVA Online's Surviving AIDS Web site. The virology section of Microbiology and Immunology On-line includes a chapter by R. Hunt titled "Vaccines: Past successes and future prospects." NIAID offers a brochure (in PDF format) titled "HIV vaccines explained--Making HIV vaccines a reality" and a fact sheet titled "Challenges in designing HIV vaccines." The NIAID Division of AIDS offers a presentation on HIV vaccines. The CDC's Divisions of HIV/AIDS Prevention provide information about vaccine research. The International AIDS Vaccine Initiative (IAVI) provides a presentation on vaccine science with a section on the state of current AIDS vaccine research and New Vaccines for the World, a report of the 6 July 2002 meeting in Barcelona. Also provided by IAVI are information about its vaccine development research, the IAVI Report, and other news coverage about AIDS vaccines, as well as summary information and a database on AIDS Vaccines in human trials. The WHO-UNAIDS HIV Vaccine Initiative makes available a collection of publications and documents about AIDS vaccines. BBC News provides an 8 July 2002 article titled "New hope for AIDS vaccine." USA Today makes available a 5 September 2001 article by S. Sternberg titled "Closer to AIDS vaccine?" HIV InSite provides a 1998 Knowledge Base chapter titled "The science of HIV vaccine development." The Body provides a collection of links to AIDS vaccine information. The HIV Vaccines Trials Network provides links to Internet resources related to HIV vaccines.

  9. Mucosal immunity. The Brown University course on developing vaccines makes available M. Petske's lecture notes (in PDF format) on mucosal immunity and vaccine development. The April-June 2001 issue of the IAVI Report had an article by E. Bass titled "New studies help put mucosal immunity on the radar." The November 2002 issue of the CDC's Emerging Infectious Diseases had an article by F. van Ginkel, H. Nguyen, and J. McGhee titled "Vaccines for mucosal immunity to combat emerging infectious diseases."

  10. Killer T cells and cell-mediated immunity. Killer T cell is defined in xrefer's New Penguin Dictionary of Science. Cells Alive provides an introduction to cytotoxic T lymphocytes (killer T cells). Kimball's Biology Pages provides an introduction to cytotoxic T lymphocytes. S. Abedon, Department of Biological Sciences, Ohio State University, Mansfield, offers an introduction to killer T cells in his MicroPort reference resource. The PersonalMD Web site makes available an article by N. Patil on T cell immunity. J. Decker, Department of Veterinary Science and Microbiology, University of Arizona, provides lecture notes on T cell-mediated immunity for an immunology course. G. Kaiser, Biology Department, Community College of Baltimore County, Catonsville Campus, offers lecture notes on T-cell mediated immunity for a microbiology course.

  11. Retrovirus is defined in xrefer's Concise Medical Dictionary. S. Baron's Medical Microbiology has a chapter on retroviruses by M. Cloyd. The Division of Medical Virology, University of Cape Town, South Africa, makes available lecture notes on human retroviruses. M. Hewlett provides lecture notes on retroviruses and HIV and AIDS as a retrovirus case study for a virology course. The NCBI Bookshelf makes available the 1997 book Retroviruses edited by J. Coffin, S. Hughes, and H. Varmus.

  12. Promising candidate vaccine. The 3 September 2002 issue of the Proceedings of the National Academy of Sciences had an article by T. Fouts et al. titled "Crosslinked HIV-1 envelope-CD4 receptor complexes elicit broadly cross-reactive neutralizing antibodies in rhesus macaques" (7). The Institute of Human Virology issued a 19 August 2002 press release about this promising multi-strain HIV candidate vaccine.

  13. Candidate microbicidal agents such as cyclodextrins. An introduction to cyclodextrins is provided by the Stoddart Group Home Page, Department of Chemistry, University of California, Los Angeles. Cyclodextrin Technologies Development, Inc. provides an introduction to cyclodextrins. A presentation about cyclodextrins and pharmaceuticals is provided by Cydex, Inc. The NIAID Division of AIDS includes a section on microbicides in its presentation on HIV prevention. The HIV/AIDS Treatment Information Service provides a resource page on microbicides. The American Foundation for AIDS Research provides a resource page on microbicides; included is a July 2002 conference report on microbicides. Johns Hopkins Medicine issued a 24 July 2001 press release about the research by J. Hildreth on cyclodextrins as HIV microbicides. The January 2002 issue of the Journal of Clinical Investigation had an article by K. V. Khanna et al. titled " Vaginal transmission of cell-associated HIV-1 in the mouse is blocked by a topical, membrane-modifying agent" (8).

  14. Mother-to-infant transmission of HIV and its prevention. The Elizabeth Glaser Pediatric AIDS Foundation provides information about pediatric AIDS and global programs to prevent mother-to-child transmission. NIAID provides a background briefing on HIV infection in infants and children. AIDS.org provides links to Internet resources on pediatric AIDS. The NIAID Division of AIDS offers information about mother-to-infant transmission in its presentation on HIV prevention. AVERT provides a presentation about mother-to-child transmission. The CDC's Global AIDS Program provides information on preventing mother-to-child transmission. The HIV InSite Knowledge Base includes a section on preventing mother-to-child transmission of HIV. WHO's Department of Reproductive Health and Research offers a resource page about mother-to-child transmission of HIV. The WHO Department of HIV/AIDS makes available a 2001 publication titled "The prevention of mother-to-child transmission of HIV: Selection and use of nevirapine."

  15. UNESCO provides information about its actions against HIV/AIDS.

  16. R. C. Gallo is at the Institute of Human Virology and the Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore.

  17. L. Montagnier is at the World Foundation for AIDS Research and Prevention, Paris.


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Volume 298, Number 5599, Issue of 29 Nov 2002, pp. 1730-1731.
Copyright © 2002 by The American Association for the Advancement of Science. All rights reserved.

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