A PROSPECTIVE-STUDY OF INFANTS BORN TO WOMEN SEROPOSITIVE FOR HUMAN IMMUNODEFICIENCY VIRUS TYPE-1
A PROSPECTIVE-STUDY OF INFANTS BORN TO WOMEN SEROPOSITIVE FOR HUMAN IMMUNODEFICIENCY VIRUS TYPE-1
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DOI：
10.1056/nejm198906223202502
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发表时间：
1989-06-22
影响因子：
158.5
通讯作者：
GRISCELLI, C
中科院分区：
文献类型：
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作者：
BLANCHE, S;ROUZIOUX, C;GRISCELLI, C
评估人类免疫缺陷病毒1型（HIV-1）从母亲传染给新生儿的风险很困难，部分原因是母亲抗体被动传染给婴儿的持续时间长达一年。为了确定艾滋病毒感染的围产期传播频率，我们研究了308名血清阳性妇女所生的婴儿，其中62%是静脉吸毒者。在出生后18个月进行评估的117名婴儿中，32名（27%）为艾滋病毒血清反应阳性或死于获得性免疫缺陷综合征（艾滋病）（n = 6）;在32名婴儿中，只有2名没有症状。另有76名婴儿（65%）血清反应阴性，没有症状，而9名（8%）血清反应阴性，但有HIV-1感染的症状。感染HIV-1的婴儿与出生时的其他婴儿在体重、身高、头围或畸形率方面没有差异，但与18个月时血清阴性的新生儿相比，他们的血清IgM水平更高（78 ± 0.01）。81 mg/dl vs. 38 . ±. 39 mg/dl; P < 0.03），其CD 4淋巴细胞计数较低（2054 . ±.每立方毫米1221对2901 .+-. 1195/mm3; P < 0.006）。母亲的危险因素和分娩途径都不是18个月时血清阳性的预测因素;然而，6名母乳喂养的婴儿中有5名血清阳性，而99名非母乳喂养的婴儿中有25名血清阳性（P < 0.01）。我们的结论是，血清反应呈阳性的母亲所生的婴儿中，约有三分之一在18个月大时将有艾滋病毒1型感染或艾滋病的迹象，这一群体中约有五分之一将死亡。
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 synptoms 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 < 0.03) and their CD4 lymphocyte counts were lower (2054 .+-. 1221 per cubic millimeter vs. 2901 .+-. 1195 per cubic millimeter; P < 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 < 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.