Acquired immunodeficiency syndrome in infants

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.