TRANSIENT SEROREVERSION IN CHILDREN BORN TO HUMAN IMMUNODEFICIENCY VIRUS 1-INFECTED MOTHERS

[摘要] Purpose of the Study. To review the clinical and laboratory data of three infants born to HIV-1-infected mothers, who became HIV-1 seronegative after 6 months of age, but subsequently became HIV-infected and seropositive.Study Population. Three infants are described from a cohort of 218 born to HIV seropositive mothers at the Maternity Ward of the Centre Hospitalier de Kigali, Rwanda, enrolled from November 1988 to June 1989. Of these, 140 infants (64.2%) became HIV-1 seronegative (based on a minimum of two negative serum samples). Three (2.1 %) of these 140 infants were subsequently found to be seropositive for HIV-1 antibodies after 6 to 9 months of seronegativity. The infants had no history of blood transfusion or exposure to contaminated needles. They were breast-fed during at least 18 months of their lives.Methods. Sera were screened for anti-HIV-1 antibodies by ELISA, and those positive were confirmed by Western Blot (WB). Serum immunoglobulins were measured by radial immunodiffusion. Mononuclear cell subpopulations were analyzed using indirect immunofluorescence and monoclonal antibodies. A double PCR was performed with three pairs of HIV-1-specific oligonucleotide primers with amplified sequences located in the gag, pol, and env region of the HIV-1 genome. A positive PCR was defined as a detectable signal for at least two of the three primer pairs.Results. The infants were HIV-1 seropositive until 6 months of age and were seronegative on the following examination at 9 months of age. They remained seronegative for 6-9 months when HIV seropositivity was again noted. Case 1 had a normal physical examination until seroconversion at 15 months (hepatosplenomegaly was noted once at 3 months of age).

[学科分类] 儿科学