Human immunodeficiency virus-1 seroprevalance among parturients in Los Angeles County Public Hospitals

Citations from the Literature t&d at birth and the others were registered later (median age 4.8 (range 0.4-72) months). HIV-l-associated signs developed in 433 (8 1.8%) of 529 seropositive infected children at a median age of 5 (0.03-84) months. These signs appeared signiBcantly earlier in the 102 children who died of HIV-l-related illness than in those who are still alive (median 3 (0.03-55) vs. 6 (0.03-84) months; P < 0.001). The cumulative proportion surviving at age 9 years was 49.5% (95% confidence interval 27-65%) and the median survival time was 96.2 months. Separate analysis of the 112 seropositive infected children followed from birth and older than 15 months gave similar resuhs. Hepatomegaly, splenomegaly, lymphadenopathy, parotitis, skin diseases and recurrent respiratory tract infections formed the mildest disease pattern. Lymphoid interstitial pneumonitis and thrombocytopenia were signs of intermediate disease. By contrast, in multivariate analysis specific secondary infectious diseases, severe bacterial infections, progressive neurological disease, anaemia, and fever were significant and independent negative predictors of survival. Growth failure, persistent oral candidosis, hepatitis and cardiopathy were associated in univariate analysis with signfiicantly shorter survival. Chtr findings suggest that the outlook for children with perinatal HIV-l infection is better than previously thought and that a new clinical staging system of single disease patterns is needed. sathclsEveIu8Deeofhamanhmmmede~vIrushlfeetion IowomsaaeekIagrepmd&IvebeaIthmrvIeesIntheUaited State& 19ll8-1989 SwcemeyPA; Gnorato IM; Allen DM; Byers RH; Fortester W; Collie D, Bledsoe G, Conneg T, Deppe D; Efird J; Edgar G; Meek B; Ruberti D, Sanders R; Sloane S Division of HIV/AIDS, Centers for Disease Control, 1600 Crifton Road, Atlanta. GA 30333, USA OBSTET GYNECOL 1992 79/4 (503-510) Cases of AIDS among women of reproductive age have increased dramatically since 1981; nearly a third of all cases among females were reported in 1990 alone. Surveillance of human immunodeBciency vims (HIV) infection among women is essential for monitoring the spread of HIV over time and identiIying specific populations and geographic areas in need of HIV counseling, testing and prevention services. Blinded (unlinked) serologic surveys were conducted in the United States and Puerto Rico in sentinel clinics providing reproductive health services to women, including family planning, prenatal care and abortion services. Seventy-eight of 94 clinics (83%) in 30 cities conducting surveys during 1988 and 1989 detected at least one HIV-positive woman. Clinic-specific prevalence ranged from O-2.28% (median 0.22%), with rates over 1% occurring in clinics predominantly on the East Coast and in Puerto Rico. Seroprevalence varied by primary type of service, race ethnicity and age group. Median rates were higher in clinics offering prenatal services and lower in abortion and family planning clinics in the same cities. In general, women 25-29 years of age showed the highest median rate of infection (0.32%) and rates were higher among black women (median 0.34%) than among Hispanic (median 0.11%) and white women

89

(median 0%). Our data indicate the need to educate women about recognizing and reducing their risk of HIV infection. Reproductive health clinics with high seroprevalence should implement voluntary HIV counseling and testing with ap propriate follow-up clinical evaluation and referral for infected women. Clinics with low prevalence should seize the opportunity to enhance HIV education and prevention efforts. HamrnhmmMkhqvirpblgcrolcevLkreuwgptdentshLasAngde~ComtyPmbiicHoqitd Hill DA; Thomas JC; Frenkel LM; Hurd Settlage R; Lee M, Yonekura ML AIDS Epidemiology Program, Los Angeles County Dept. Hlth Servs., 600 Commonwealth, Los Angeles, CA W5, USA OBSTET GYNECOL 1992 79/5 I (657-660) To estimate the prevalence of human immunodeticiency virus type 1 (HIV-l) among parturients in an ana with a high cumulative incidence of AIDS, an HIV seroprevalence study was conducted in 1988 in Los Angeles County. Test results were available from 8485 (86.1%) of the 9860 women delivering at four public hospitals. The test results were linked to demographic and medical information available from routinely collected delivery records. Three specimem were HIV-positive, for a seroprevalence of 3.5 per 10 000. The seropositive women were all Latina. The prevalence of HIV among women delivering at all hospitals in Los Angeles County has been shown to be relatively low compared with that of other metropolitan areas with a high number of AIDS cases, such as New York city, but appears to be even lower among women delivering at public hospitals during this time period. This low prevalence is attributed to the predominance of Latinas, who may have lower levels of infection, among public hospital parturients. The relatively low prevalence of HIV among injection drug users in Los Angeles County may contribute to the overall lower prevalence among women in Los Angeles County compared with those in New York city. This study supplements county-specific data obtained from statewide blinded neonatal testing by providing details on HIV seroprevalence among the catchment populations of public hospitals in Los Angeles county.

Portincasa P; Conti G, Re MC; Chezzi C Istituto di hiicrobiologia, Vniversita &gli Studi di Parma. Facolta di Medicina e Chirurgia, 43100 Parma, ITA BR MED J 1992 304/6841 (1539-1542) Objective - To detect infection with HIV-l by IgA and IgM response at birth in children born to HIV-l seropositive mothers. Design -Western blotting and radioimmune western blotting on stored sera from infected and uninfected babies born to HIV-l seropositive mothers. Sera were pretreated to remove IgG. Setting - Parma and Bologna, Italy. Subjects I2 infected and five uninfected babies born to HIV-l seropositive mothers and three babies born to seronegative mothers. Main outcome measures - Effectiveness of western blotting and radioimmune western blotting in detecting antiInt J Gynecol Obstet 40