Natural history and serologic diagnosis of infants born to human immunodeficiency virus-infected women

Article Abstract:

The first cases of acquired immunodeficiency syndrome (AIDS) in infants were reported in 1983, and that number has grown to a current population of over 1,300 cases of AIDS in children. In addition to children who can be presently classified as having AIDS, many more infants and children are infected with the human immunodeficiency virus (HIV, which causes AIDS) and have a high probability of developing AIDS at some time in the future. Obstetrical screening of newborns is now recommended for those who had fetal exposure to the virus, that is, screening of newborns with HIV-infected mothers. The current study explores the natural history of AIDS in children who belong to this high risk population. Women who were seen in a major center's gynecologic service, and identified as being at high risk for AIDS, were asked to participate in a study of AIDS risk for both themselves and their infants. All women who were identified as high-risk agreed to participate. Of these women, 25 percent were found to be infected with HIV as determined by blood testing (seropositive), but none had yet developed AIDS. Ninety percent of these mothers were Afro-American with an average age of 25.8 years. Approximately half continued to abuse drugs during pregnancy. The first 20 children born to HIV-infected mothers were evaluated at birth, and at 2, 4, 6, 9, 12, and 18 months of age by physical examination and blood testing. Of these children, eight were diagnosed with HIV infection. There was no significant difference between the infected children and the non-infected children on physical examination. The infected children suffered from opportunistic infections and failure-to-thrive. Six of the eight infected children produced antibodies against HIV that could be detected by blood testing; this may represent an important marker of the disease in young children. In this study, 8 of 20 young children at high risk for HIV infection became infected during the 18-month period of observation. (Consumer Summary produced by Reliance Medical Information, Inc.)

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The human immunodeficiency virus-infected infant

Article Abstract:

Infants born to mothers who are infected with human immunodeficiency virus (HIV, the virus that causes AIDS) have a rate of infection which ranges between 25 to 50 percent. The risk of HIV infection in these newborns was analyzed in a prospective study. The infants were followed for a minimum period of 18 months so that estimates of the rate of HIV transmission from HIV-infected mother to fetus could be made (vertical transmission). This is particularly important since this congenital infection by HIV has a strong and pronounced effect on the growth of infected children. However, it is important to note that even this study failed to identify factors which are important to the vertical transmission of HIV. The report reveals that if the mother was properly approached it was often possible to gain permission to test her newborn for HIV. Unanswered and pressing issues include the events that condition the transfer of HIV from mother to fetus, the maternal conditions which may moderate the rate of transmission, and the development of skills and tests which clearly allow identification of the infection in newborns. Once there is better recognition of these factors, methods which reduce or block the transmission of HIV from mother to fetus may be developed. (Consumer Summary produced by Reliance Medical Information, Inc.)

editorial

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Maternal and neonatal characteristics associated with HIV infection in infants of seropositive women

Article Abstract:

Low birth weight and fetal infections may contribute to the transmission of HIV infection between an infected pregnant woman and her baby. Some infants born to HIV-infected mothers develop HIV infection, but others do not. Among 134 infants born to HIV-infected mothers, 31 were HIV-positive and 103 were HIV-negative. Forty-eight percent of the HIV-positive infants had a low birth weight, compared with 22% of the HIV-negative infants. Sixteen percent of the infants with HIV infection were born small for their gestational age, compared with 6% of the infants without HIV infection. Bacterial infections occurred more often among HIV-infected newborns than in healthy newborns. Mothers of HIV-positive infants were more likely to develop other sexually transmitted diseases or use illicit drugs during their pregnancy than mothers of HIV-negative infants.

Diseases, Pregnant women, Infants, HIV infection in children, Pediatric HIV infections

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