This Program Project focusses on two aspects of childhood AIDS: the study, care and treatment of infants born to mothers infected with human immunodeficiency virus (HIV); and the education of adolescents considered at high risk for HIV infection. Childhood AIDS in Boston is rapidly expanding in scope and intensity, and this is an ideal community in which to carry out such projects. Five projects are envisioned tied together by administrative, clinical and laboratory cores. The first project is a multidisciplinary study of the natural history of childhood HIV infection (starting with pregnant HIV antibody- positive women and following their offspring throughout the course of their disease) combined with several treatment protocols. The natural history projects emphasize neurologic, infectious, developmental, pulmonary, cardiac, gastrointestinal and immunologic manifestations. The treatment protocols are designed to investigate intravenous immunoglobulin and various nutritional interventions. The second project is a detailed analysis of the pathophysiology of gastrointestinal infection with HIV, using both material from the natural history study and material from primates infected with simian immunodeficiency virus. The third and fourth projects are laboratory protocols, one for the study of peptides of HIV -- their use as reagents, their immunogenicity, and their utility in unravelling the structure of HIV native proteins; and the other for an investigation of the structure, synthesis and function of the envelope glycoprotein of HIV. The fifth project is an outreach project for the care of infants with AIDS and their families and for the counselling and education of adolescents, both those contemplating a gay lifestyle and those at high risk for intravenous drug use and pregnancy. The care of infants will be coordinated through drug use and pregnancy. The care of infants will be coordinated through a group of nurses who will develop case management protocols and design comparative trials of promising modes of care. The adolescent protocols both are designed to evaluate the efficacy of imaginative educational programs. Together, these five protocols represent an integrated program for the study of childhood HIV infection, its treatment and prevention. They will use the best skills of this institution in a multidisciplinary approach.
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