Rate of transmission of human immunodeficiency virus type 1 infection from mother to child and short-term outcome of neonatal infection. Results of a prospective cohort study
W. A. Andiman, B. J. Simpson, B. Olson, L. Dember, T. J. Silva and G. Miller
Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06510.
In an attempt to determine the rate of transmission of infection from human
immunodeficiency virus type 1 (HIV-1) antibody-positive women to their
offspring and to describe the short-term outcome of perinatal infection, we
enrolled 62 infants in a prospective cohort study during a 30-month period
and followed them up for an additional 6 months. The clinical, immunologic,
and serologic status of the children was assessed prospectively. Fourteen
subjects were symptomatic: 3 had acquired immunodeficiency syndrome, 5 had
signs and symptoms that were compatible with HIV-1 infection (Centers for
Disease Control, Atlanta, Ga, class P2A), and 6 had ill-defined symptoms
that could not be definitely attributed to HIV. Our data indicated that the
maximum rate of vertical transmission of HIV-1 infection in New Haven,
Conn, was less than 30%, and the rate of HIV-1-associated disease occurring
during the first 3 years of life was 16%. The mean and median time to loss
of maternal antibody, as detected by Western blot in seroreverters, was
approximately 7 months, and the half-life of passive antibody was 38 days.
A continued close follow-up of children in the cohort studied, and others
like it, is critical to learn the full range of outcomes of HIV infection
in the pediatric population.
