HIV INFECTION IN CHILDREN OF IV DRUG ABUSERS

艾滋病的发病率 儿童的数量在增加，感染源通常是 母亲 大约75%的艾滋病毒感染儿童是 静脉吸毒者父母的后代。 诊断HIV感染 然而，在新生儿和无症状婴儿中， 所有艾滋病毒血清阳性妇女所生的婴儿都被动地 转移的母体抗体可能持续到甚至 超过15个月的年龄。 因此，感染和未感染的婴儿 不能根据常规免疫学或 血清学检测 该提案的一个假设是， 受感染的婴儿具有HIV特异性B和T细胞， 可以在体外进行利用， 和未感染的婴儿 艾滋病毒特异性免疫的新测试（在- 体外HIV抗体合成、抗体克隆型与HIV 抗原特异性淋巴细胞增殖）将与试验相结合 用于聚合酶链反应、HIV病毒培养和HIV 抗原在多测试诊断方法来解决这个问题。 艾滋病毒感染在儿科人群中导致广泛的 一系列临床和免疫紊乱，范围从 无症状至重度疾病，免疫活性至重度 免疫功能低下状态。 艾滋病毒攻击的主要目标系统是 免疫系统和神经系统。 第二个假设是 疾病进展的速度与 初步临床表现和实验室检查结果 神经和免疫系统的系统研究 艾滋病病毒状况、艾滋病毒特异性免疫力和艾滋病毒抗原水平将提供 深入了解临床，病毒学和免疫学谱， 这种疾病。 此次调查的一个重要特点是 数据管理功能 诊断HIV感染的能力 婴儿期和对疾病机制的理解 进步应该使我们更接近发展和监测 针对这种致命疾病的治疗策略。

The incidence of acquired immunodeficiency syndrome (AIDS) in children is increasing, the source of infection usually being the mother. Approximately 75% children with HIV infection are offspring of IV drug abuser parent(s). Diagnosis of HIV infection in newborns and asymptomatic infants is, however, a problem because all infants born to HIV seropositive woemen have passively transferred maternal antibodies which may persist up to and even beyond 15 months of age. Infected and uninfected infants thus cannot be distingushed on the basis of routine immunological or serological testing. A hypothesis of this proposal is that HIV infected infants have HIV-specific B & T cells whose properties can be exploited in-vitro to enable the distrinction between infected and uninfected infants. Novel tests of HIV-specific immunity (in- vitro HIV antibody synthesis, antibody clonotype pattern and HIV antigen specific lymphoproliferation) will be coupled with tests for the polymerase chain reaction, HIV viral cultures and HIV antigen in a multi-test diagnostic approach to this probolem. HIV infection in the pediatric population results in a wide spectrum of clinical and immunologic distrubances, ranging from asymptomatic to severely ill and form immunocompetent to severely immunocompromised status. Main target systems attacked by HIV are the immune system and the nervous system. A second hypothesis to be tested is that rapidity of disease progression is closely linked to initial clinical presentation and laboratory findings. Systematic investigations of the neurological and immunological status, HIV-specific immunity and HIV antigen levels will provide insights into the clinical, virologic and immunologic spectrum in this disease. An important feature of this investigation will be data management. The ability of diagnosing HIV infection in infancy and an understanding of the mechanisms involved in disease progression should bring us closer to developing and monitoring therapeutic strategies against this deadly disease.