ACQUIRED IMMUNODEFICIENCY DISEASE IN HAITIAN CHILDREN

迈阿密的第一批儿童艾滋病病例诞生于1979年。第一 诊断是在1982年和1985年9月，74例 在60名婴儿和儿童中发现了HTLV-III感染 家庭。最初的招生时间是从1983年3月到 1984年10月。17个索引案例和相同数量的匹配案例 比较病例和他们各自的家庭被登记和跟踪 自入学以来一直是纵向的。对该群体的随访率超过 90%在本授权期内。诊断和实验室参数 包括HTLV-III分离和血清学程序已经建立， 儿童艾滋病已被定义在这一组中。孩子们的母亲 围产期感染的指示病例本身也感染了HTLV-III和 有严重的免疫功能障碍，尽管临床上健康 接生感染婴儿的时间，相当数量的母亲 随后发展成艾滋病。母亲们持续感染着 病毒，并可能产生多个受影响的兄弟姐妹。在出生的20个婴儿中 在之前发现的儿科艾滋病指数病例后，65%的母亲 随后的孩子也会被感染。与这一高比率形成对比 围产期感染方面，尚无意外感染的证据。 在家庭中。总体病死率为35%，尽管在某些情况下 临床症状如淋巴细胞性间质性肺炎的发生率 只有14%表明可能会有不同的临床结果 与对病毒的不同免疫反应有关。现建议： 登记在初始诊断之前和之后诊断的所有存活索引病例 注册期间和后续共约75例儿科艾滋病病例用于 再用四年时间扩大我们的数据库，并延长 后续行动。这将提供有关儿科的晚期结局的信息。 艾滋病、HTLV-III在家庭中传播的可能性和 HTLV-III病毒阳性母亲的远期结局评估。病毒 将对分离株进行鉴定，并对HTLV-III的抗体反应 测量以评估病毒变异、抗体的各自作用 形成与临床疾病。

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.