Age at AIDS diagnosis for children with perinatally acquired HIV

The human immunodeficiency virus (HIV) can be transmitted from mother to child in utero, during birth, or after birth through breast milk. While the majority of children born to HIV-positive mothers are not infected, almost all carry maternal antibodies. The number of maternal or perinatal exposures can be determined by screening all newborns for these antibodies, while maintaining the anonymity of mother and child. Combining newborn screening results with traditional surveillance data from New York City, we estimate that among maternally infected children, almost 14% will be diagnosed in the 1st year of life and, approximately 11-12% each year after, through age 7. This implies a median diagnosis age of 4.1 years, and suggests that in the majority of infected children, AIDS will not develop until after the 1st few years of life. We also examine the diagnosis age distribution for all children (infected and not) with a positive screen. We conclude that by approximately 7 years of age, 17% of children who test positive will be diagnosed with clinical AIDS, according to a yearly rate of > 2%. Based on these results, the perinatally acquired pediatric epidemic can be projected from the newborn screening data.