[A survey of children with HIV/AIDS in highly epidemic villages of AIDS].
OBJECTIVE
To estimate prevalence of HIV/AIDS among children and the transmission routes in a highly endemic villages of AIDS.


METHODS
Totally 208 high-risk women of child bearing age and 159 of their children aged 0 - 14 years were investigated. Their medical histories of blood donation or transfusion were collected, blood samples were taken and sera were separated for HIV test. Enzyme-linked immunosorbent assay (ELISA) and Western blot assay were performed for HIV antibody. The Nested-polymerase chain reaction (PCR) assay amplifying gag gene p17 was performed on samples of children aged less than 18 months.


RESULTS
Thirty-seven HIV infected cases were found among 159 children aged 0 - 14 years of whom 33 were infected by mother-to-child transmission (89.2%, 33/37), 3 by blood transfusion (8.1%, 3/37) and one by iatrogenic route (2.7%, 1/37). Sixty seven mothers who were seropositive for HIV and their 86 children who were born after 1992 were investigated, 33 cases of them were infected with HIV. The rate of vertical transmission was 38.4% (33/86). The HIV vertical transmission rate among mothers with AIDS (68.8%, 22/32) was significantly greater than that among mothers with asymptomatic HIV infection (20.4%, 11/54, P < 0.05). The number of children infected with HIV through vertical transmission increased from 1993 to 2001. Among 37 children infected with HIV, 12 cases developed AIDS and 4 of them died, of whom 2 cases died from tuberculosis. The morbidity of AIDS was 27.3% (9/33). Ninety three point nine percent (31/33) of infected mothers didn't know their HIV seropositive status before pregnancy and delivery. Of 8 pregnant women infected with HIV, one had aggravation of AIDS, 2 miscarried, 2 terminated their pregnancy and 3 continued their pregnancy.


CONCLUSIONS
Mother-to-child transmission of HIV was the major route of HIV/AIDS transmission to the children. The main reason leading to HIV infection in children was the lack of prenatal HIV counseling and testing for the high-risk women of childbearing age and lake of interventions. The countermeasures must be taken to control the further transmission of AIDS in order to protect the health of women and children in the highly endemic areas of AIDS.
Zhuang
Ke
K
Department of Infectious Diseases, Zhongnan Hospital, Wuhan University, Wuhan 430071, China.
Gui
Xi-en
XE
Luo
Jia-la
JL
Wang
Xiao-rong
XR
Su
Bo
B
Zhang
Yong-xi
YX
D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission*; D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D015683:Gene Products, gag / Q000235:genetics; D015488:HIV Antigens / Q000235:genetics; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission*; D015497:HIV-1 / Q000235:genetics / Q000276:immunology; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D016133:Polymerase Chain Reaction; D015995:Prevalence; D014764:Viral Proteins; D054301:gag Gene Products, Human Immunodeficiency Virus
D000914:Antibodies, Viral; D015683:Gene Products, gag; D015488:HIV Antigens; D014764:Viral Proteins; D054301:gag Gene Products, Human Immunodeficiency Virus; C054858:p17 protein, Human Immunodeficiency Virus Type 1