Lancet. 1991 Feb 2;337(8736):253-60.
600 children born to HIV-infected mothers by June 15, 1990, in ten European centres were followed to study the natural history of HIV infection and the vertical transmission rate. They were seen at birth, every 3 months up to 18 months of age, and every 6 months thereafter. At last follow-up, 64 children were judged to be HIV infected and 343 had lost antibody and were presumed uninfected. The initial clinical feature in infected children was usually a combination of persistent lymphadenopathy, splenomegaly, and hepatomegaly, though 30% of children presented with AIDS, or with oral candidosis followed rapidly by AIDS. An estimated 83% of infected children show laboratory or clinical features of HIV infection by 6 months of age. By 12 months, 26% have AIDS and 17% die of HIV-related disease. Subsequently, the disease progresses more slowly and most children remain stable or even improve during the second year. The vertical transmission rate, based on results in 372 children born at least 18 months before the analysis, was 12.9% (95% Cl 9.5-16.3%). Virus has been repeatedly isolated in an additional small proportion of children (2.5%, 95% Cl 0.7-6.3%) who lost maternal antibody and have remained clinically and immunologically normal. Without a definitive virological diagnosis, the monitoring of immunoglobulins, CD4/CD8 ratio, and clinical signs could identify HIV infection in 48% of infected children by 6 months, with a specificity of more than 99%.
1990年6月15日前，欧洲十个中心的600名感染HIV的母亲所生儿童接受了随访，以研究HIV感染的自然史和垂直传播率。在出生时、18个月龄前每3个月、此后每6个月对他们进行检查。在最后一次随访时，64名儿童被判定感染了HIV，343名儿童抗体消失，推测未感染。感染儿童最初的临床特征通常是持续性淋巴结病、脾肿大和肝肿大的组合，不过30%的儿童表现为艾滋病，或先出现口腔念珠菌病，随后很快发展为艾滋病。据估计，83%的感染儿童在6个月龄时出现HIV感染的实验室或临床特征。到12个月时，26%的儿童患有艾滋病，17%死于与HIV相关的疾病。随后，疾病进展较为缓慢，大多数儿童在第二年保持稳定甚至有所好转。根据对分析前至少18个月出生的372名儿童的研究结果，垂直传播率为12.9%（95%可信区间9.5-16.3%）。在另外一小部分失去母体抗体但临床和免疫状态正常的儿童中（2.5%，95%可信区间0.7-6.3%），病毒被反复分离出来。在没有明确病毒学诊断的情况下，通过监测免疫球蛋白、CD4/CD8比值和临床体征，在6个月时可识别48%的感染儿童中的HIV感染，特异性超过99%。
