This study is designed (1) to determine whether infants born to mothers at risk for human immunodeficiency (HIV) infection differ by mothers' willingness to accept HIV screening and (2) to examine health characteristics of infants born to high risk women to compare the health status of infants who remain HIV positive to the health of infants who remain HIV negative or seroconvert to HIV negative during the first 15 months of life. Demonstration that clinical and developmental outcomes differ between these two groups may provide clinicians with biological markers for predicting infants prone to complications resulting from prenatal HIV exposure. Perinatal transmission is the predominant route of infection of the HIV in infants, yet prenatal screening remains voluntary. At the Johns Hopkins Hospital Obstetric Clinic, serving an urban high risk population, only 50% of HIV high risk pregnant women consent to HIV screening. Few studies have investigated infants of unscreened high risk mothers for their risk of HIV infection as compared to infants born to screened mothers. The study will be conducted in two phases, the first employing a case-control design to determine if there is a significant difference in the rate of HIV infection in infants born to unscreened versus screened mothers. Second, each infant (N-176) will be followed prospectively over a 15 month period to examine health characteristics (growth parameters, a number of recurrent infections, Bayley developmental scores at 6 and 12 months) of infants who remain HIV positive as compared to infants who remain or seroconvert of HIV negative. Analysis includes Chi-square test of independence for the case-control design and multivariate analyses in the prospective phase to simultaneously examine several independent variables (birthweight, sex, length of mother's HIV positivity) for their contribution to remaining HIV positive at 15 months of age. Because the majority of symptoms in infants resulting from perinatally acquired AIDS usually begin during the first six months of life, there is a clear need to describe biological markers associated with remaining HIV positive at 15 months of age. Second, identification of factors amenable to intervention during infancy may reduce the high morbidity and mortality associated with perinatally acquired HIV infection.
| Butz, A M; Hutton, N; Joyner, M et al. (1993) HIV-infected women and infants. Social and health factors impeding utilization of health care. J Nurse Midwifery 38:103-9 |
| Quinn, T C; Kline, R; Moss, M W et al. (1993) Acid dissociation of immune complexes improves diagnostic utility of p24 antigen detection in perinatally acquired human immunodeficiency virus infection. J Infect Dis 167:1193-6 |
| Aylward, E H; Butz, A M; Hutton, N et al. (1992) Cognitive and motor development in infants at risk for human immunodeficiency virus. Am J Dis Child 146:218-22 |
| Butz, A M; Stephenson, H; Hutton, N et al. (1992) Care of HIV-risk infants: nursing outreach by PNPs. J Pediatr Health Care 6:138-45 |
| Butz, A; Hutton, N; Larson, E (1991) Immunoglobulins and growth parameters at birth of infants born to HIV seropositive and seronegative women. Am J Public Health 81:1323-6 |
