ACQUIRED IMMUNE DEFICIENCY SYNDROME IN FAMILIES

Abstract

In the first family, a child developed weight loss and diarrhea shortly after birth. At 5 months of age the child was hospitalized because of fever. A lung biopsy done because of a persistent pulmonary infiltrate revealed P. carinii; C. neoformans was isolated from the tissue. Immunogiobulins were elevated but mitogen stimulation studies and the numbers of B and T cells were normal. Disseminated CMV disease and T cell depletion were seen at autopsy. Thirty months later the patient's father, after 3 months of weight loss, developed C. neoformans meningitis. Immunologic studies were consistent with AIDS. The mother and a second child born one year after the first are both normal.

In the second family, a child developed a fatal pneumonia over a 2 week period. Immunologic studies were not obtained and an autopsy was not done. A second child born 1 year later developed weight loss and oral candidiasis at 5 months of age. At 7 months of age this child was admitted because of persistent candidiasis and diarrhea. Immunologic studies revealed a reversed T4/TB ratio, increased immunoglobulins, decreased natural killer activity, and normal mitogen stimulation studies. K. avium was isolated from a lung biopsy, findings at autopsy were consistent with AIDS. One month after the child was hospitalized, his father was noted to be losing weight; immunologic studies were consistent with AIDS but no opportunistic infection has been documented.

In these 2 families, infants developed AIDS or presumed AIDS well in advance of their effected fathers. Just as AIDS in parents is a risk factor for the development of AIDS in their unborn children. AIDS in infants identifies parents at high risk as well. Both situations should be used to identify individuals who may benefit from interventional strategies to prevent the progression of AIDS.

Log in or create a free account to read this content

Gain free access to this article, as well as selected content from this journal and more on nature.com

Access through your institution

or

Sign in or create an account

Continue with Google

Continue with ORCiD