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Results of a Prospective Cohort Study

Warren A. Andiman, MD; B. Joyce Simpson, RN; Betty Olson; Laura Dember, MD; Thomas J. Silva; George Miller, MD

Am J Dis Child. 1990;144(7):758-766.

Abstract
• 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.

(AJDC. 1990;144:758-766)

Author Affiliations
From the Departments of Pediatrics (Drs Andiman and Miller and Mr Silva) and Epidemiology and Public Health (Drs Andiman and Miller and Ms Olson), Yale University School of Medicine (Dr Dember), New Haven, Conn, and the Department of Nursing, Yale–New Haven (Conn) Hospital (Ms Simpson). Dr Dember is now with the Hospital of the University of Pennsylvania, Philadelphia.

Footnotes
Accepted for publication November 8, 1989.

Reprint requests to Department of Pediatrics, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510 (Dr Andiman).

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