RESUMO
In the 13-month period between June 1985 and July 1986, 27 children were found to be HIV positive in the Princess Margaret Hospital in Nassau. Nineteen of the children had clinical AIDS, four were in the prodromal phase and four were symptom free. The clinical course of these infants is presented. Of the 18 mothers 16 were screened and were all seropositive and asymptomatic. They remained healthy in spite of subsequent pregnancies in nine of them (56%) during a follow-up period of between 13 and 65 months (mean 40 months). Fifteen of the 18 mothers were Haitian but only three had other risk factors, throwing doubt on the value of selective screening in Afro-Caribbean countries.
PIP: From June 1985 through July 1986, HIV screening (ELISA/Abbott) was performed on all donated blood, on family members of those found to be HIV positive, and those who were thought to be infected on clinical groups alone at the Princess Margaret Hospital in Nassau. Positive cases were confirmed in Miami, Florida, using the Western blot method. Laboratory confirmation of infections was made whenever possible. Selection of the 27 children for testing was based on clinical suspicion in 19, because of seropositive siblings in 4, and as the result of screening paternal blood donations in 4. The 27 children were born to 18 mothers. 19 of the HIV-positive children were classified as having Acquired Immune Deficiency Syndrome (AIDS), 4 had AIDS-related complex (ARC), and 4 were HIV positive but asymptomatic. The 19 children with AIDS exhibited clinical signs and symptoms of their disease within the 1st 18 months of life (range 2-18 months). They were hospitalized on 79 occasions and seen frequently as outpatients because of bacterial infections. Children with ARC became symptomatic later in general than those with AIDS (range 3 months to 6 years). The course of the disease was variable. Of the 27 HIV-positive children, 14 were less than 15 months of age when tested initially. 9 of these children developed AIDS (5 have died), 2 have ARC, and 3 were symptom-free at the end of the period, although 1 is known to have developed AIDS subsequently. 15 of the 18 mothers were Haitian, but only 3 had other risk factors, raising doubt about the value of selective screening in Afro-Caribbean countries.
