GI DYSFUNCTION IN CHILDREN BORN TO HIV-INFECTED WOMEN

尽管儿童艾滋病的发病率迅速上升， 了解儿童艾滋病毒感染的自然史，或 导致疾病进展的因素。 胃肠 功能障碍是儿童多系统疾病的主要组成部分 艾滋病 胃肠道可能是恶性肿瘤的靶点， 感染和粘膜损伤。 因此，重要的免疫和 消化过程受到损害，恶性循环反复或 长期腹泻、营养不良和免疫缺陷可能随之发生。 那里 没有关于以下事件的发生率、病因或结局的前瞻性数据： HIV感染儿童胃肠功能障碍。 由于马里兰州医院的现有项目，我们 有一个独特的队列， 艾滋病病毒。 这一出生队列将为纵向 腹泻和生长迟缓的研究。 该项目的目的是确定 腹泻、生长不良和肠道感染的发生， 免疫功能障碍、热量摄入减少和营养不良 感染艾滋病毒的儿童吸收不良。 现有技术， 疫苗开发中心将使我们能够确定一个 肠道病原体的综合电池，并评估的作用， 病原体特异性体液和分泌免疫应答在根除 感染和预防免疫介导的粘膜损伤。 吸收不良 饮食中的糖和脂肪将被检测非侵入性使用系列 生长和拟人化的措施，饮食史，并分析 选择血液中的营养素。 孩子们将接受评估 常规检查是否有免疫性疾病 的价值 胃肠道功能障碍作为临床结果的预测因子， 测定 这些信息将为设计随后的研究提供基础 探讨重症腹泻的防治方法， 艾滋病儿童的消瘦 早期干预可以改变疾病 并将有助于降低发病率和死亡率 与HIV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.