ACQUIRED IMMUNODEFICIENCY DISEASE IN HAITIAN CHILDREN

迈阿密的第一个儿童艾滋病病例出生于1979年。 第一 从1982年到1985年9月，共诊断出74例 婴儿和儿童中的HTLV-III感染已在60 户 最初的招募期为1983年3月至 一九八四年十月。 17例索引病例和相同数量的匹配病例 比较病例及其各自的家庭进行了登记和随访 自入组以来，纵向。 这组的随访率超过了 90%在当前的时间段内。 诊断和实验室参数 包括HTLV-III分离和血清学程序， 儿童艾滋病就是在这个群体中定义的。 的母亲 围产期感染的指示病例本身感染HTLV-III， 有严重的免疫功能障碍，虽然在临床上健康， 在分娩受感染的婴儿时，许多母亲 后来发展成艾滋病。 这些母亲持续感染 病毒，并可能产生多个受影响的同胞。 20个婴儿出生 在先前确定的儿科艾滋病指数病例后， 随后的孩子也会被感染。 与此相反， 围产期感染，没有偶然感染的证据 在家庭中。 总体病死率为35%，尽管在某些情况下， 淋巴细胞性间质性肺炎等临床综合征， 只有14%的人认为， 与对病毒的不同免疫反应有关。 提出要 入组所有在初次诊断之前和之后诊断的存活指标病例， 入组期间，共随访约75例儿童艾滋病病例， 再用四年时间来扩大我们的数据库，并延长 随访 这将提供有关儿童晚期结局的信息。 艾滋病、HTLV-III在家庭中传播的可能性以及 评估HTLV-III病毒阳性母亲的晚期结局。 病毒 分离株将被表征，对HTLV-III的抗体应答将被 测量以评估病毒变异、抗体 形成和临床疾病。

The first cases of pediatric AIDS in Miami were born in 1979. The first diagnoses were made in 1982 and through September, 1985, 74 cases of HTLV-III infection in infants and children have been identified in 60 households. The initial enrollment period was from March, 1983 until October, 1984. Seventeen index cases and an equal number of matched comparison cases and their respective households were enrolled and followed longitudinally since enrollment. The follow-up rate on this group exceeded 90% in the current grant period. Diagnostic and laboratory parameters including HTLV-III isolation and serologic procedures were established and pediatric AIDS has been defined in this group. The mothers of perinatally-infected index cases are themselves infected with HTLV-III and have profound immune dysfunction and although clinically healthy at the time of delivering an infected infant, a significant number of the mothers subsequently develop AIDS. The mothers are persistently infected with the virus and may give birth to multiply affected sibships. Of 20 infants born to mothers after a previously identified pediatric AIDS index case, 65% of the subsequent children are infected. In contrast to this high rate of perinatal infection, there has been no evidence of casual infection noted in households. The overall case fatality rate is 35%, although in certain clinical syndromes such as lymphocytic interstitial pneumonitis, the rate is only 14% suggesting that there may be distinct clinical outcomes perhaps associated with different immune responses to the virus. It is proposed to enroll all surviving index cases diagnosed before and after the initial enrollment period and to follow a total of some 75 pediatric AIDS cases for four more years to enlarge our data base and to extend the period of follow-up. This will provide information on the late outcome of pediatric AIDS, the possibility of HTLV-III transmission in households and an evaluation of late outcome in HTLV-III virus-positive mothers. Virus isolates will be characterized and antibody responses to HTLV-III will be measured to evaluate the respective roles of viral variation, antibody formation and clinical disease.