Salvini F, Scarlatti G, Bossi A, Pinzani R, Zibordi F, Giovanettoni C, Plebani A
Department of Pediatrics "G. e D. De Marchi," University of Milan, Italy.
AIDS Patient Care STDS. 2001 Feb;15(2):59-65. doi: 10.1089/108729101300003645.
This study describes the clinical, immunologic, and virological characteristics of 30 vertically human immunodeficiency virus type 1 (HIV-1)-infected children older than 8 years of age (long-survivors) before the introduction of protease inhibitors therapy. All of them were followed from birth. At the age of 8 years, 7 children presented no HIV-1-associated signs or only mild ones and only 5 had severe clinical manifestations (acquired immune deficiency virus [AIDS]). The remaining 18 children presented moderate signs with some immunodeficiency. The follow-up from 8 years of age (3.5 years on the average) showed that 6 children remained asymptomatic and were therefore defined as long-survivors nonprogressors (average, 13 years) and only 4 children developed AIDS. Progressive encephalopathy was the most striking clinical manifestation at follow-up and occurred in 6 children (always after immunodeficiency) with a polymorphic picture combining eye movement alterations, pyramidal signs and symptoms and mental deterioration. The majority of our long-survivors carried a virus with nonsyncytia-inducing phenotype, thus confirming its association with long survival. A switch to syncytia-inducing phenotype was observed only in 2 cases during the follow-up, but their clinical status did not change at follow-up.
本研究描述了在蛋白酶抑制剂疗法引入之前，30名年龄超过8岁的垂直感染1型人类免疫缺陷病毒（HIV-1）儿童（长期存活者）的临床、免疫和病毒学特征。他们均从出生起就接受随访。8岁时，7名儿童没有出现与HIV-1相关的体征或仅有轻微体征，只有5名儿童有严重的临床表现（获得性免疫缺陷病毒[艾滋病]）。其余18名儿童有中度体征及一些免疫缺陷。从8岁开始的随访（平均3.5年）显示，6名儿童仍无症状，因此被定义为长期存活的无进展者（平均13岁），只有4名儿童发展为艾滋病。进行性脑病是随访中最突出的临床表现，6名儿童出现该症状（均在免疫缺陷后），表现多样，包括眼球运动改变、锥体束征和症状以及精神衰退。我们的大多数长期存活者携带非细胞病变诱导型表型的病毒，从而证实了其与长期存活的关联。随访期间仅在2例中观察到向细胞病变诱导型表型的转变，但他们的临床状态在随访中没有变化。
