Manaloto C R, Caringal L T, Santiago E G, Basaca-Sevilla V, Perrault J G, Hayes C G, Anthony R L
US Naval Medical Research Unit No 2 Detachment, Manila.
Int J STD AIDS. 1996 May-Jun;7(3):212-20. doi: 10.1258/0956462961917500.
Fifteen term babies born to 12 HIV-1 antibody positive Filipino CSW have been monitored for signs and symptoms of HIV-1 infection. Eleven babies were enrolled in the study within the first 6 months after birth; 4 others were enrolled at 4, 9, 11 and 21 months of age respectively. Every 3 months after enrolment, each baby received a physical examination, serum was tested for HIV-1 antibodies and p24 antigen and peripheral blood mononuclear cells were cultured for isolation of virus. After a mean follow-up period of 39.3 months (range 7-72 months), virus isolation and serum p24 antigen assays confirmed that 2 babies have been infected with HIV-1. If the 4 babies less than 18 months of age were excluded, the vertical transmission rate was 18.2%. Seven babies who have been monitored for a minimum of 25 months (range 31-60 months) lost their maternal antibodies but 6 of them subsequently developed indeterminant Western blots (WB); reactivity to p24 and/or gp120/ 160 but no reactivity to gp41. Of the remaining 6 babies, still less than 25 months of age (range 7-24 months), 2 lost their maternal antibodies within one year. The other 4 continued to recognize either p24 or gp120/160 well after the accepted 15-month period for loss of maternal antibody. Although a diagnosis could not be established upon the basis of these laboratory findings, clinical observations (failure to thrive, anergy, persistent generalized lymphadenopathy and recurrent pneumonias) mimicked HIV-1 infection. However, because these clinical features are common among many babies in the developing world, their usefulness in supporting a diagnosis of perinatal HIV-1 infection is limited.
对12名HIV-1抗体呈阳性的菲律宾性工作者所生的15名足月儿进行了HIV-1感染体征和症状监测。11名婴儿在出生后的头6个月内纳入研究；另外4名分别在4个月、9个月、11个月和21个月时纳入。纳入研究后每3个月，对每个婴儿进行体格检查，检测血清中的HIV-1抗体和p24抗原，并培养外周血单核细胞以分离病毒。经过平均39.3个月（范围7 - 72个月）的随访，病毒分离和血清p24抗原检测证实2名婴儿感染了HIV-1。如果排除4名18个月以下的婴儿，垂直传播率为18.2%。7名接受了至少25个月（范围31 - 60个月）监测的婴儿失去了母体抗体，但其中6名随后出现了不确定的免疫印迹法（WB）结果；对p24和/或gp120/160有反应，但对gp41无反应。其余6名婴儿，年龄仍小于25个月（范围7 - 24个月），其中2名在1年内失去了母体抗体。另外4名在超过公认的母体抗体消失15个月期限后，仍能很好地识别p24或gp120/160。尽管根据这些实验室检查结果无法确诊，但临床观察（生长发育迟缓、无反应性、持续性全身淋巴结肿大和反复肺炎）类似HIV-1感染。然而，由于这些临床特征在发展中世界的许多婴儿中很常见，它们在支持围产期HIV-1感染诊断方面的作用有限。
