Infants born to HIV infected mothers.

Eighty infants born to HIV-infected mothers were studied prospectively at Children's Hospital, Bangkok, Thailand from February 1989 to June 1991. The risk factors for acquisition of HIV infection were analyzed in 33 mothers (41.25%) including a history of being sex workers and having husbands who had extramarital sexual contact (22.5% each), having other sexually transmitted diseases (20.0%) and being IV drug users (6.25%). All infants appeared clinically normal without congenital anomaly, 22.5% (18 of 80) were of low birth weight with 91.43% (64 of 70) positive for HIV-antibody at birth. On follow up 56.25% (9 of 16) seroreversed during age 6 to 15 months, whereas 5 infants who were HIV-Ab negative at birth remained Ab negative on follow up for up to 15 months. One of 49 infants who attended the follow up clinic had been suffering from recurrent diarrhea, failure to thrive and encephalopathy since 9 months old; she weighed 6.7 kg at 15 months of age and remained positive for HIV-Ab.

Early versus late onset neonatal septicemia at Children's Hospital.

An analysis was made of 695 cases of neonatal sepsis at Children's Hospital from 1982 to 1986. The incidence of neonatal sepsis and septicemia were 6.5 and 2.4 per 1,000 livebirths respectively. There were 178 cases of septicemia with onset during the first four days of life (early onset group) and 77 cases with onset after four days of life (late onset group). Both groups did not differ significantly in sex, birth weight and gestational age. Most of the cases had low birth weight and were premature. Pneumonia was the common associated infection. Omphalitis was found more frequently in the early onset of septicemia, whereas, NEC and skin infection were found more in the late onset group. Pseudomonas aeruginosa and Klebsiella pneumoniae were the major causes of infection in both groups. Staphylococcus was more common in late septicemia. No statistical difference in major complications was found between the two groups. Fatality rate in early and late septicemia was 32.6 and 28.2 per cent respectively.

Protective efficacy of plasma-derived hepatitis beta vaccine in preventing perinatal transmission of HBV infection in infants of HBsAg/HBeAg positive mothers.

Two hundred and four newborn infants of HBsAg/HBeAg carrier mothers were randomly assigned into three groups. Group A (69 infants) received full-dose HB vaccine, group B (70 infants) received half-dose HB vaccine at birth, 1 month, 3 months and group C (65 infants) were untreated control group. After twelve months follow-up the cumulative incidence of HBs antigenemia was 17.2%, 30% in group A, B respectively as compared with 78.4% in group C (p less than 0.001). The protective efficacy rates (PER) of group A and B were 78.1% and 61.7% respectively (p less than 0.05). The vaccine was also effective in preventing persistent HBsAg carriers (HBsAg positive for at least 6 months). The PER of group A and B were at least 74.9% and 49.2% respectively (p less than 0.001) at 1 year follow-up. From the practical point of view and economic reasons administration of full-dose HB vaccine give better protection to high risk infants.