       Document 0887
 DOCN  M9440887
 TI    Diarrheal morbidity during the first 2 years of life among HIV-infected
       infants.
 DT    9404
 AU    Kotloff KL; Johnson JP; Nair P; Hickman D; Lippincott P; Wilson PD;
       Clemens JD; Division of Infectious Diseases, University of Maryland
       School of; Medicine, Baltimore 21201.
 SO    JAMA. 1994 Feb 9;271(6):448-52. Unique Identifier : AIDSLINE
       MED/94125537
 AB    OBJECTIVE--To determine the incidence, cause, and patterns of diarrhea
       during the first 2 years of life among infants infected perinatally with
       the human immunodeficiency virus (HIV). DESIGN--A cohort study in which
       infants were enrolled shortly after birth and followed up longitudinally
       using biweekly surveillance for the occurrence of diarrhea. Stool
       specimens collected at the onset of diarrhea were evaluated for
       enteropathogens. Infants who were infected with HIV were compared with
       uninfected infants. SUBJECTS--Infants born to HIV-infected women at the
       University of Maryland Hospital, Baltimore, were recruited at 0 to 3
       months of age. This analysis included 58 infants enrolled in the cohort
       and followed up at least 15 months (unless death intervened) whose HIV
       status was established (18 HIV-infected infants and 40 HIV-uninfected
       infants). MEASUREMENTS AND RESULTS--The overall incidence of diarrhea in
       HIV-infected infants was 3.2 episodes per 12 child-months compared with
       1.5 episodes per 12 child-months among HIV-uninfected infants (incidence
       density ratio, 2.2; P < .05). An enteropathogen was identified in stool
       specimens collected during 20% of diarrheal episodes occurring in
       HIV-infected infants and during 25% of diarrheal episodes occurring in
       HIV-uninfected infants. Episodes that persisted for 14 days or longer
       were significantly more common among HIV-infected infants. The peak
       incidence of diarrhea occurred at 0 to 5 months of age for HIV-infected
       infants compared with 6 to 11 months for HIV-uninfected infants. Early
       onset of diarrhea (< 6 months old) in HIV-infected infants was
       associated with the later development of persistent episodes of
       diarrhea, and those with persistent episodes had more severe HIV
       infection, characterized by a significantly higher frequency of
       opportunistic infections and lower CD4+ T-lymphocyte counts by 1 year of
       age. CONCLUSION--Both acute and persistent episodes of diarrhea are
       major sources of morbidity in HIV-infected infants. Moreover, persistent
       diarrhea is a marker for rapid progression of HIV disease.
 DE    AIDS-Related Opportunistic Infections/PHYSIOPATHOLOGY  Cohort Studies
       Diarrhea, Infantile/*EPIDEMIOLOGY/ETIOLOGY  Human  HIV
       Infections/*CONGENITAL/COMPLICATIONS/*PHYSIOPATHOLOGY  Incidence  Infant
       Morbidity  Prospective Studies  Support, U.S. Gov't, P.H.S.  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

