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The epidemiology of pediatric acquired immunodeficiency syndrome
Insights
Human T-lymphotropic virus type III (HTLV-III) infection in children often presents before age two. Most pediatric cases result from in utero transmission from infected mothers.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Epidemiology
Background:
- Human T-lymphotropic virus type III (HTLV-III) infection presents unique challenges in pediatric populations.
- Early-onset clinical manifestations are common, typically appearing before two years of age.
Purpose of the Study:
- To describe the spectrum and transmission patterns of HTLV-III infection in children.
- To project the potential increase in pediatric AIDS cases based on projected pregnancies.
Main Methods:
- Review of clinical manifestations and transmission routes in pediatric HTLV-III infection.
- Analysis of projected pregnancies in HTLV-III-positive women to estimate future pediatric AIDS cases.
Main Results:
- The majority of pediatric HTLV-III infections manifest before age two.
- In utero transmission occurs in 35-65% of pregnancies from infected mothers; discordant twin infections are noted.
- Other transmission routes include blood transfusions, sexual abuse, and needle use; no evidence of child-to-child horizontal transmission was found.
Conclusions:
- Pediatric HTLV-III infection has a defined clinical spectrum and primary transmission routes.
- A significant increase in pediatric AIDS cases is anticipated due to projected pregnancies in infected women.
Abstract:
HTLV III infection of children exhibits a relatively narrow spectrum in which the majority of patients develop clinical manifestations before the age of 2 years. In most instances the disease is transmitted in utero, whereby 35-65% of HTLV III-positive women give birth to an infected child. Discordant infection in twins is described. In fewer cases the disease is acquired through blood transfusions. In exceptional cases transmission via sexual abuse or use of needles may occur in young children. We have no evidence of intrafamilial horizontal disease transmission from child to child. The number of children with the disease may increase sharply. Around 2000 pregnancies in HTLV III-infected women are projected in New York City in the next year. Should all these pregnancies be completed, several hundred additional cases of pediatric AIDS may be expected in 1986.