A Prospective Study of Infants Born to Women Seropositive for Human Immunodeficiency Virus Type 1

Abstract

Assessment of the risks of transmission of infection with human immunodeficiency virus type 1 (HIV-1) from mother to newborn is difficult, partly because of the persistence for up to a year of maternal antibodies transmitted passively to the infant. To determine the frequency of perinatal transmission of HIV infection, we studied from birth 308 infants born to seropositive women, 62 percent of whom were intravenous drug abusers. Of 117 infants evaluated 18 months after birth, 32 (27 percent) were seropositive for HIV or had died of the acquired immunodeficiency syndrome (AIDS) (n = 6); of the 32, only 2 remained asymptomatic. Another 76 infants (65 percent) were seronegative and free of symptoms, whereas 9 (8 percent) were seronegative but had symptoms suggestive of HIV-1 infection. The infants infected with HIV-1 did not differ from the others at birth with respect to weight, height, head circumference, or rate of malformations, but as compared with newborns who were seronegative at 18 months, their serum IgM levels were higher (78 +/- 81 mg per deciliter vs. 38 +/- 39 mg per deciliter; P less than 0.03) and their CD4 lymphocyte counts were lower (2054 +/- 1221 per cubic millimeter vs. 2901 +/- 1195 per cubic millimeter; P less than 0.006). Neither maternal risk factors nor the route of delivery was a predictor of seropositivity at 18 months; however, 5 of the 6 infants who were breast-fed became seropositive, as compared with 25 of 99 who were not (P less than 0.01). We conclude that approximately one third of the infants born to seropositive mothers will have evidence of HIV-1 infection or of AIDS by the age of 18 months, and that about one fifth of this group will have died.

Imunoglobulinas séricas em crianças com exposição perinatal ao vírus da imunodeficiência humana

“…Outros relatos apresentam resultados semelhantes, destacando-se o estudo longitudinal francês, em que, adicionalmente, níveis mais elevados de IgM foram observados em sangue de cordão umbilical, no grupo infectado 22,23 . A identificação de níveis elevados de IgM mais precocemente pode ser explicada por ser a IgM a principal imunoglobulina sintetizada pelo recém-nascido e lactente jovem, sendo a maturação na produção de IgG e IgA mais tardia 24 .…”

Monitoring scale-up of antiretroviral therapy programmes

“…In countries where only antibody tests are used for testing, HIV status cannot be confirmed in a child born to an HIV-infected mother until the age of about 18 months. 20 Therefore, in these settings children in need of cotrimoxazole are all those younger than 18 months born to HIVinfected mothers and all HIV-infected children over the age of 18 months. In…”

Prevención de la transmisión materno-infantil del virus de inmunodeficiencia humana de tipo 1 en Uruguay: 1987-2009. Análisis de las diferentes medidas adoptadas

“…E n el año 2008 se estimaba que había 33,4 millones de personas infectadas por el virus de inmunodeficiencia humana (VIH), de los cuales 15,7 millones eran mujeres y 2,1 millones tenían menos de 15 años de edad habiendo sido infectados primariamente a través de la transmisión materno infantil (TMI) [1][2][3][4][5] . Al momento actual, la infección de niños por esta vía es en gran medida evitable por lo que la prevención de la transmisión vertical del VIH es una prioridad mundial.…”