Follow-up of vertically HIV-1-infected long-surviving children.
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.
Department of Pediatrics "G. e D. De Marchi," University of Milan, Italy.
F
F
Salvini
G
G
Scarlatti
A
A
Bossi
R
R
Pinzani
F
F
Zibordi
C
C
Giovanettoni
A
A
Plebani
D000293:Adolescent; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000235:genetics / Q000276:immunology* / Q000635:transmission*; D020276:HIV Long-Term Survivors / Q000706:statistics & numerical data*; D015497:HIV-1; D006304:Health Status; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D010641:Phenotype