Abstract
OBJECTIVE--To determine the occurrence of vertical transmission of HIV-I from women positive for the virus and the prognosis for their babies. DESIGN--Women presenting in labour were tested for HIV-I. Their newborn babies were also tested. Women positive for the virus were followed up with their babies for two years. SETTING--Teaching hospital in Lusaka, Zambia. SUBJECTS--1954 Women, of whom 227 were seropositive. Of 205 babies, 192 were positive for HIV-I. After birth 109 seropositive mothers and their babies and 40 seronegative mothers and their babies were available for follow up. MAIN OUTCOME MEASURES--Serological examination of mothers and their babies by western blotting. Birth weight and subsequent survival of babies. Women and babies were tested over two years for signs of seroconversion and symptoms of infection with HIV, AIDS related complex, and AIDS. RESULTS--Of the 109 babies born to seropositive mothers and available for follow up, 18 died before 8 months, 14 with clinical AIDS. Of the 91 remaining, 23 were seropositive at 8 months. By 24 months 23 of 86 surviving babies were seropositive, and a further five infected babies had died, four were terminally ill, 17 had AIDS related complex, and two had no symptoms. The overall rate of perinatal transmission was 42 out of 109 (39%). The overall mortality of infected children at 2 years was 19 out of 42 (44%). Before the age of 1 year infected children had pneumonia and recurrent coughs, thereafter symptoms included failure to thrive, recurrent diarrhoea and fever, pneumonia, candidiasis, and lymphodenopathy. All babies had received live attenuated vaccines before 8 months with no adverse affects. CONCLUSIONS--Vertical transmission from infected mothers to their babies is high in Zambia and prognosis is poor for the babies. Perinatal transmission and paediatric AIDS must be reduced, possibly by screening young women and counselling those positive for HIV-I against future pregnancy.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Chiodo F., Ricchi E., Costigliola P., Michelacci L., Bovicelli L., Dallacasa P. Vertical transmission of HTLV-III. Lancet. 1986 Mar 29;1(8483):739–739. doi: 10.1016/s0140-6736(86)91129-3. [DOI] [PubMed] [Google Scholar]
- Cowan M. J., Hellmann D., Chudwin D., Wara D. W., Chang R. S., Ammann A. J. Maternal transmission of acquired immune deficiency syndrome. Pediatrics. 1984 Mar;73(3):382–386. [PubMed] [Google Scholar]
- Lapointe N., Michaud J., Pekovic D., Chausseau J. P., Dupuy J. M. Transplacental transmission of HTLV-III virus. N Engl J Med. 1985 May 16;312(20):1325–1326. doi: 10.1056/NEJM198505163122012. [DOI] [PubMed] [Google Scholar]
- Minkoff H., Nanda D., Menez R., Fikrig S. Pregnancies resulting in infants with acquired immunodeficiency syndrome or AIDS-related complex. Obstet Gynecol. 1987 Mar;69(3 Pt 1):285–287. [PubMed] [Google Scholar]
- Ragni M. V., Urbach A. H., Kiernan S., Stambouli J., Cohen B., Rabin B. S., Winkelstein A., Gartner J. C., Zitelli B. Z., Malatack J. J. Acquired immunodeficiency syndrome in the child of a haemophiliac. Lancet. 1985 Jan 19;1(8421):133–135. doi: 10.1016/s0140-6736(85)91904-x. [DOI] [PubMed] [Google Scholar]