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Mother-to-child transmission of HIV infection. The European Collaborative Study
Insights
The study followed 271 children born to mothers with human immunodeficiency virus (HIV). It found a 24% vertical transmission rate, with most infected infants developing symptoms by nine months.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- Human immunodeficiency virus (HIV) infection in mothers poses a risk of vertical transmission to newborns.
- Understanding the outcomes for infants born to HIV-infected mothers is crucial for clinical management and public health strategies.
Purpose of the Study:
- To assess the vertical transmission rate of HIV from infected mothers to their children.
- To monitor the clinical and immunological status of infants born to HIV-infected mothers.
- To determine the pattern of antibody loss in infants born to HIV-infected mothers.
Main Methods:
- A multicentre collaborative study followed 271 children born to HIV-infected mothers from birth.
- Clinical examinations, immunological assessments, and virological tests (virus isolation, antigen detection) were performed.
- Follow-up duration varied, with a significant proportion followed for over one year.
Main Results:
- The estimated vertical transmission rate of HIV was 24%.
- Ten children developed AIDS or AIDS-related complex by nine months of age, with five deaths.
- Twenty-two children had symptoms suggestive of HIV infection, with nine confirmed infections.
- The median age of antibody loss was 10.3 months; none lost antibody and subsequently became seropositive.
- Five antibody-negative infants were presumed infected based on virus isolation or antigen detection, yet remained clinically and immunologically normal.
Conclusions:
- Vertical transmission of HIV is a significant concern, with a substantial proportion of infected infants developing severe disease early in life.
- While many infants lose maternal antibodies, persistent antibodies or positive virological markers indicate ongoing infection.
- Further research is needed to understand long-term outcomes and potential interventions for HIV-infected infants.
Abstract:
271 children born to HIV-infected mothers in 8 European centres are being followed up from birth in a multicentre, collaborative study. By June, 1988, 45% had been followed for over 1 year: 10 had developed AIDS or AIDS-related complex, all by the age of 9 months, of whom 5 had died. 22 other children had symptoms or signs suggestive of HIV infection; of these, 12 had immunological abnormalities, 9 of whom were infected. 5 children had problems not related to HIV, including 3 neonatal deaths. The other 234 children are immunologically normal and clinically well. The median age of antibody loss was 10.3 months, although 1 did not lose antibody until over 18 months. None lost antibody and then became and remained seropositive. Of 100 children followed for more than 15 months, 19 had persistent antibody, and 5 were antibody-negative but presumed to be infected because of virus isolation or antigen detection; these 5 children were clinically and immunologically normal. The estimated vertical transmission rate was 24%.