PATHOGENETIC AND VIROLOGIC ASPECTS OF PEDIATRIC AIDS

本提案的总体目的是确定以下风险： 在前瞻性队列中出现有症状的HIV感染和AIDS 对至少200名血清反应阳性母亲所生的婴儿进行了研究， 静脉注射吸毒者或吸毒者的异性伴侣。 我们将 前瞻性跟踪血清反应阳性母亲所生的儿童， 尝试定义与以下疾病相关的生物学和血清学风险因素： 传播和深入研究儿科的自然史 感染 另一个重要的目标是发展病毒学和血清学 测试，并确定流行病学和行为风险因素， 描述婴儿有感染艾滋病毒高风险的母亲的特征 感染和疾病。 这将使我们能够选择目标， 可能预防婴儿感染的预防或化疗， 可以减轻这种感染。 我们还将寻找艾滋病毒株之间的生物学差异， 白蛋白血症水平的数量差异，以及 抗体对病毒蛋白质的反应。 此外，我们将使用 病毒分离、病毒抗原检测和聚合酶椅反应 技术，以区分，尽早在生活中，婴儿谁是 真正被感染的是那些有被动抗体的人。 这些研究结合了联合收割机在临床护理中的积极计划， 对感染艾滋病毒的儿童进行监测， 使用现代分子和流行病学技术的艾滋病毒生物学。 该计划的优势在于能够联合收割机流行病学， 临床、病毒学和分子生物学方法， 母婴艾滋病问题的实验室研究。

The overall purpose of this proposal is to determine the risk of developing symptomatic HIV infection and AIDS in a prospective cohort study of at least 200 infants born to seropositive mothers who are intravenous drug abusers or heterosexual partners of drug users. We will follow prospectively children who are born to seropositive mothers and attempt to define biologic and serologic risk factors associated with transmission and to study intensively the natural history of the pediatric infection. Another important goal is to develop virologic and serologic tests and to identify epidemiologic and behavioral risk factors to characterize mothers whose infants have a high risk of developing HIV infection and disease. This will allow us to select targets for prophylaxis or chemotherapy which might prevent infection in infants or might ameliorate such infection. We will also look for biologic differences among strains of HIV, for quantitative differences in the level of leukoviremia, and the differences in antibody responses to viral protein products. In addition, we will use virus isolation, detection of viral antigens and polymerase chair reaction techniques to distinguish, as early in life as possible, infants who are truly infected from those with passive antibodies. These studies combine an active program in the clinical care and surveillance of HIV-infected children with laboratory investigations of HIV biology using contemporary molecular and epidemiologic techniques. The program's strength lies in the ability to combine epidemiologic, clinical, virologic, and molecular biologic approaches for the study of the maternal-infant AIDS problem in one laboratory setting.