Related Experiment Videos
Acquired immunodeficiency syndrome in infants
Insights
This study identified fourteen infants with acquired immunodeficiency syndrome (AIDS), primarily of Haitian descent, exhibiting failure to thrive and opportunistic infections. Findings suggest transmission of an unidentified infectious agent, potentially via perinatal routes.
Area of Science:
- Pediatrics
- Immunology
- Infectious Diseases
Background:
- Identified fourteen infants with acquired immunodeficiency syndrome (AIDS) in a metropolitan area between 1980-1983.
- Patients were predominantly of Haitian parentage, with two cases in offspring of non-Haitian intravenous drug abusers.
- Clinical presentation included failure to thrive, persistent Candida albicans oral infections, chronic pulmonary infiltrates, hepatosplenomegaly, lymphadenopathy, and diarrhea.
Purpose of the Study:
- To describe the clinical and immunological features of a newly identified pediatric acquired immunodeficiency syndrome (AIDS).
- To investigate potential transmission routes and causative agents of this infant AIDS.
- To characterize opportunistic infections and outcomes in affected infants.
Main Methods:
- Clinical case identification and retrospective review of medical records.
- Immunologic profiling including T-cell subset ratios, immunoglobulin levels, and immune complexes.
- Identification of opportunistic pathogens and autopsy findings.
Main Results:
- Predominant clinical features: failure to thrive, oral candidiasis, pulmonary infiltrates, hepatosplenomegaly, lymphadenopathy, diarrhea.
- Immunologic abnormalities: inverted T-cell subset ratios, elevated immunoglobulins, circulating immune complexes; lymphopenia was uncommon.
- Opportunistic infections: Pneumocystis carinii, cytomegalovirus, Candida albicans; bacterial sepsis was a major cause of mortality.
- Two infants presented with disseminated lymphadenopathic Kaposi's sarcoma.
Conclusions:
- Observations suggest transmission of an unidentified infectious agent causing pediatric AIDS, likely through transplacental, perinatal, or postnatal routes.
- The findings highlight a distinct pattern of AIDS in infants compared to adults.
- Further research is needed to identify the causative agent and understand transmission dynamics.
Abstract:
Fourteen infants with clinical and laboratory features of an acquired immunodeficiency syndrome were identified in a single metropolitan area from November 1980 to July 1983. Patients were predominantly of Haitian parentage, although two cases occurred in offspring of non-Haitian intravenous drug abusers. Only one patient had received a blood transfusion before the development of clinical findings. The predominant clinical findings included failure to thrive, persistent infection of the oral mucosa by Candida albicans, chronic pulmonary infiltrates, hepatosplenomegaly, lymphadenopathy, and diarrhea. Immunologic studies showed most of the infants to have inverted ratios of T-cell subsets, greatly increased immunoglobulin levels, and circulating immune complexes. Lymphopenia was not common, as it is in adult patients. Infectious agents responsible for opportunistic infections in this series included Pneumocystis carinii, herpesviruses, particularly cytomegalovirus, and C. albicans. Bacterial infections were common, and gram-negative sepsis was the major cause of death in the seven infants who have died. At autopsy, two infants had disseminated lymphadenopathic Kaposi's sarcoma. These observations suggest the likelihood of transplacental, perinatal, or postnatal transmission of an as yet unidentified infectious agent that causes this disease.