The Relationship between the Human Immunodeficiency Virus and the Acquired Immunodeficiency Syndrome (Draft)

DRAFT
Novick and Rubinstein, 1987; European Collaborative Study, 1991). However, studies have
consistently shown that of infants born to HIV-infected mothers, only the 15-40 percent of
infants who become HIV-infected before or during birth go on to develop immunosuppression
and AIDS, while babies who are not HIV-infected do not develop AIDS (D'Arminio et al., 1990;
Prober and Gershon, 1991; European Collaborative Study, 1991; Lambert et al., 1990;
Lindgren et. 1991; Andiman et al., 1990; Johnson et al., 1989; Rogers, 1989; Hutto et al.,
1991). In other words, the only factor that predicts whether a child will develop AIDS is
whether he or she is infected with HIV. Moreover, in those infants who do acquire HIV and
develop AIDS, the rate of disease progression varies directly with the severity of the disease
in the mother at the time of delivery (European Collaborative Study, 1992; Blanche et al.,
1994).
Almost all infants born to seropositive mothers have detectable HIV antibody, which
may persist for as long as 15 months (CDC, 1987b). In a French study of 22 infants born to
HIV-infected mothers, seven babies had antibodies to HIV after one year and all developed
AIDS. The other fifteen children showed a complete loss of maternally acquired HIV
antibodies, and remained healthy. Of the babies who developed AIDS, virus was found in four
of four infants tested. HIV was not found in the fifteen children who remained healthy (Douard
et al., 1989; Gallo, 1991 a).
In the European Collaborative Study, children born to HIV-seropositive mothers are
followed from birth in ten European centers. A majority of the mothers have a history of
injection drug use. A recent report showed that none of the 343 children who had lost
maternally transferred HIV antibodies (i.e. they were truly HIV-negative) had developed AIDS
or persistent immune deficiency. In contrast, among 64 children who were truly HIV-infected
(i.e. they remained HIV antibody positive), 30 percent presented with AIDS within 6 months of
age, or with oral candidiasis followed rapidly by the onset of AIDS. By their first birthday, 26

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