HIV & HTLV-I COHORT STUDIES OF HAITIAN WOMEN AND INFANTS

我们建议研究人类免疫缺陷病毒 (HIV)和人类嗜光性病毒1型（HTLV-I）感染 随后，3000名海地妇女及其后代怀孕 到24个月大。 初步研究表明，8%至 这一人群中9%的孕妇曾感染艾滋病毒 HTLV-I组为10%。 我们将评估潜在的风险因素 导致逆转录病毒感染的高流行率， 包括性接触，输血， 在诊所和非专业人员进行的注射。 血液 将从妊娠早期和中期的妇女中获得样本， 在分娩时和分娩后的一年和两年。 脐带血 并每隔3个月对婴儿采血 直到24个月大。 经过培训的社区卫生工作者将 确保积极跟踪初级保健参与者 计划与建立记录进行社区为基础的 问题研究 我们将确定艾滋病毒和HTLV-I感染的影响 关于怀孕结果（流产、死产和 出生体重）;婴儿生长;新生儿，婴儿。和两年 以及卡介苗和麻疹的安全性和免疫原性 接种疫苗 这项研究的结果将确定 血清反应阳性妇女所生婴儿感染情况及鉴别 可能与以下因素有关的因素：a） 艾滋病毒和HTLV-I的母婴传播，B）获得 妇女在分娩后感染艾滋病毒和HTLV-I，以及c） 婴幼儿早期获得逆转录病毒感染 血清反应阴性的女性所生 我们将确定血清学标准， 早期活动性HIV和HTLV-I感染的母体抗体 我们将确定从出生到发病的时间， 感染婴儿的临床疾病。 这项前瞻性队列研究的结果将有助于确定 HIV和HTLV.I感染的流行病学和自然史 在高风险的发展中国家人群中。 定量 数据将帮助卫生保健提供者制定战略， 在这一人群和类似人群中控制HIV和HTLV-I 在全世界都有。

We propose to study the effects of Human Immunodeficiency Virus (HIV) and Human Lymphotropic Virus Type 1 (HTLV-I) infections on pregnancy in 3000 Haitian women and their offspring followed through 24 months of age. Preliminary studies indicate that 8% to 9% of pregnant women in this population have been infected with HIV and 10% with HTLV-I. We will evaluate potential risk factors contributing to the high prevalence of retrovirus infections in this population including sexual contacts, blood transfusions, and injections administered in clinics and by lay personnel. Blood specimens will be obtained from women in early and mid pregnancy, at delivery and at one and two years after delivery. Cord blood will be obtained and infants will be bled at 3 month intervals until 24 months of age. Trained community health workers will assure active follow-up of participants in a primary health care program with an established record for conducting community based studies. We will determine the effect of HIV and HTLV-I infections on the outcome of pregnancy (abortions, stillbirths and birthweight); infant growth; neonatal, infant. and two year mortality; and the safety and immunogenicity of BCG and measles vaccinations. The results of this study will define the rate of infection in infants born to seropositive women and identify factors that might be associated with a) the efficiency of maternal-infant transmission of HIV and HTLV-I, b) the acquisition of HIV and HTLV-I infections by women after delivery, and c) the acquisition of retrovirus infections in early childhood for infants born to seronegative women. We will identify serologic criteria for differentiating passive maternal antibodies from active HIV and HTLV-I infections in early infancy and we will determine the time from birth to onset of clinical disease in infected infants. The results of this prospective cohort study will help to define the epidemiology and natural history of HIV and HTLV.I infections in a high risk developing country population. The quantitative data will assist health care providers to develop strategies for the control of HIV and HTLV-I in this and similar populations throughout the world.