GI DYSFUNCTION IN CHILDREN BORN TO HIV-INFECTED WOMEN

尽管儿童艾滋病的发病率迅速上升，但几乎没有 了解儿童感染艾滋病毒的自然历史，或 导致疾病进展的因素。胃肠道 功能障碍是儿童多系统疾病的主要组成部分。 得了艾滋病。胃肠道可能成为恶性肿瘤的靶子， 感染和粘膜损伤。因此，至关重要的免疫学和 消化过程受到损害，反复或反复出现恶性循环 随之而来的可能是长期腹泻、营养不良和免疫缺陷。那里 目前尚无关于本病的发生率、病因或结果的前瞻性数据 HIV感染儿童的胃肠功能障碍。 由于马里兰大学医院现有的项目，我们 有一群感染了艾滋病的妇女所生的独特的孩子 艾滋病病毒。这一出生队列将为纵向 腹泻和生长停滞的研究。 这个项目的目的是确定 腹泻，生长不良，以及出现肠道感染， 免疫功能障碍、卡路里摄入量减少和营养 感染艾滋病毒的儿童吸收不良。有关技术，请访问 疫苗开发中心将允许我们确定一种 全面检测肠道病原体，并对其作用进行评价 病原体特异性体液和分泌性免疫反应在根除中的作用 感染和预防免疫介导的粘膜损伤。吸收不良 的膳食糖和脂肪将被非侵入性地检测到 生长和拟人化的测量，饮食历史和分析 血液中精选的营养素。孩子们将接受评估 例行公事地寻找免疫疾病的证据。的价值 胃肠功能障碍作为临床结果的预测指标 下定决心。 这些信息将为后续研究的设计提供基础 为了解严重腹泻的防治情况， 在患有艾滋病的儿童中消瘦。早期干预可能会改变疾病 进展，并将有助于降低发病率和死亡率 与艾滋病毒感染有关。

Despite the rapidly increasing incidence of pediatric AIDS, little is known about the natural history of HIV infection in children, or the factors responsible for disease progression. Gastrointestinal dysfunction is a major component of the multisystem disease of children with AIDS. The gastrointestinal tract can be the target of malignancy, infection, and mucosal injury. As a result, vital immunologic and digestive processes are compromised and a vicious cycle of recurrent or prolonged diarrhea, malnutrition, and immunodeficiency may ensue. There is no prospective data regarding the incidence, etiology, or outcome of gastrointestinal dysfunction in children with HIV infection. Because of existing programs at the University of Maryland Hospital, we have a unique cohort of children born to women who are infected with the AIDS virus. This birth cohort will provide the basis for a longitudinal study of diarrhea and growth faltering. The aim of this project is to determine the relationship between diarrhea, poor growth, and the occurrence of enteric infection, immunologic dysfunction, diminished caloric intake, and nutrient malabsorption in children infected with HIV. Technology available at the Center for Vaccine Development will allow us to identify a comprehensive battery of enteropathogens, and to evaluate the role of pathogen-specific humoral and secretory immune responses in eradicating infection and preventing immune-mediated mucosal injury. Malabsorption of dietary sugars and fats will be detected noninvasively using serial growth and anthropomorphic measures, dietary histories, and analysis of selected nutrients in the blood. The children will be assessed routinely for evidence of immunologic disease. The value of gastrointestinal dysfunction as a predictor of clinical outcome will be determined. This information will provide the basis for designing subsequent studies to investigate the prevention and treatment of severe diarrhea and wasting in children with AIDS. Early interventions may alter disease progression, and will be helpful in decreasing morbidity and mortality associated with HIV infection.