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

我们建议研究人类免疫缺陷病毒的影响 艾滋病病毒(HIV)和人类1型淋巴病毒(HTLV-I)感染 3000名海地妇女及其子女随后怀孕 在24个月大的时候。初步研究表明，8%至 这一人群中9%的孕妇感染了艾滋病毒 HTLV-I则为10%。我们将评估潜在的风险因素 造成我国逆转录病毒感染高发的原因 这一人群包括性接触，输血和 在诊所和非专业人员进行注射。血样 样本将从怀孕早期和中期的妇女身上获得， 在交付时和交付后一年和两年。脐带血 婴儿将每隔3个月进行一次抽血 直到24个月大。训练有素的社区卫生工作者将 确保初级卫生保健参与者的积极跟踪 具有以社区为基础的实施记录的计划 学习。我们将确定艾滋病毒和HTLV-I感染的影响 关于妊娠结局(堕胎、死产和 出生体重)；婴儿生长；新生儿，婴儿。和两年 死亡率；卡介苗和麻疹的安全性和免疫原性 接种疫苗。这项研究的结果将定义 血清阳性妇女所生婴儿的感染和鉴定 可能与a)效率相关的因素 母婴传播艾滋病毒和HTLV-I，b)获得 妇女在分娩后感染艾滋病毒和HTLV-I型病毒的情况，以及c) 婴幼儿早期获得逆转录病毒感染的研究 出生于血清阴性的女性。 我们将确定区分被动的血清学标准 早期活动性HIV和HTLV-I感染的母源抗体 婴儿期，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的流行病学和自然史I.感染 在高风险的发展中国家人口中。量化的 数据将帮助医疗保健提供者制定战略，以 该人群及类似人群中HIV和HTLV-I的控制 在世界各地。

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.