Rosendahl C, Wintergerst U, Lutz R, Belohradsky BH; International Conference on AIDS.
Int Conf AIDS. 1989 Jun 4-9; 5: 314 (abstract no. T.B.P.163).
Immunodeficiency clinic, University Hospitals for Sick Children, Munich, W-Germany
OBJECTIVE: Since 1984 infants and children with typical HIV-associated symptoms are cared for in Munich's University Children's Hospitals. Until now 44 newborns with intrauterine/perinatal HIV-exposition only from Bavaria are followed up in a national multicenter study. The aim of this investigation is to define the transmission rate from mother to child, the factors influencing manifestations of AIDS, and to evaluate the benefit of prophylaxis and therapy with immunoglobulins and zidovudine. METHODS: Infants are followed up in intervals of three months beginning at delivery. In addition to maternal HIV-antibody-status, we try to accumulate further virological and immunological data of the mother as they occur during pregnancy. Children with proven HIV-infection receive monthly infusions of standard-immunoglobulin in a dose of 400 mg/kg bw. Those with full blown AIDS are treated with immunoglobulin plus oral zidovudine (3.5 mg/kg bw qid). RESULTS: Data of the mother's pregnancy are available for 15 out of the 44 children. Four mothers had definitive viremic episodes (p24- antigen, virus-isolation) during pregnancy. Of all others only HIV-Ab-positivity was known. 15 children lost their HIV-antibodies and remained clinically and immunologically healthy. In 15 other children the HIV-infection could be confirmed. 5 of them died of AIDS, 7 receive prophylactic immunoglobulin-infusions, 3 are treated with immunoglobulins plus zidovudine (Retrovir(R)). Two of the zidovudine-recipients had neurological symptoms which improved upon therapy. The third child fell ill with a pneumocystis carinii pneumonia which could successfully be treated. In 14 children, younger than 15 months of age and HIV-ab-positive, HIV-infection could not be ascertained so far. Clinical symptoms, virological results and immunological parameters of all patients will be presented in detail. CONCLUSION: With cautious interpretation of our data the transmission rate is 40%. A suspected correlation between proven viremia during pregnancy and HIV-transmission to the child should be confirmed by more frequent virological tests of the mother during her pregnancy. Infants with confirmed HIV-infection may benefit of the immunoglobulin-prophylaxis since this medication seems to suppress bacterial and viral infections and possibly decreases HIV-replication. Immunological parameters could not be influenced by this therapy.
Publication Types:
Keywords:
- AIDS Vaccines
- Acquired Immunodeficiency Syndrome
- Child
- Drug Therapy, Combination
- Female
- HIV Antibodies
- HIV Infections
- HIV Seropositivity
- Humans
- Infant
- Infant, Newborn
- Pneumonia, Pneumocystis
- Pregnancy
- Zidovudine
- drug therapy
- therapy
- virology
Other ID:
UI: 102177417
From Meeting Abstracts