Natural History of HTLV

Natural History of HTLV-111/LAV Infections in Children

Gwendolyn B. Scott, Lee Anisman, Marie-Luise Zaldivar, Wade Parks,
University of Miami School of Medicine, Department of Pediatrics, Miami, FL.

Longitudinal investigation of 71 children with HTLV-111/LAV infection in South Florida between January 1980 and June 1985 reveals a broader spectrum of disease than originally appreciated. A subset of 24 children have had physical exams and immune studies at three month intervals for 2 years as part of an ongoing natural history study. Thirty-seven have AIDS, 32 have AIDS related complex (ARC) and 3 are asymptomatic carriers. Sixty-eight cases represent transmission from an infected mother to her infant, 3 are transfusion associated. Ages at present range from birth to 6 years. Disease developed in the first year of life in 73%, 3 were asymptomatic until age 4. In followup, several well defined clinical syndromes were identified; lymphoid interstitial pneumonitis 39%, recurrent infections 34%, cardiomyopathy/myocarditis 32%, encephalopathy 10%, hepatitis 10% and protein calorie malnutrition 8%. Asymptomatic children have immune defects and generalized lymphadenopathy. Overall mortality rate is 35%, but is higher in those children with opportunistic infection, 62%. All children have evidence of HTLV-111/LAV infection by virus isolation and/or serology. This infection causes multisystem involvement in children and a syndrome-oriented approach will aid in the diagnosis of new cases.

Reprinted from the conference program of the International Conference on Acquired Immunodeficiency Syndrome (AIDS), Paris, France, June 23-25, 1986, Communication 39 S 4b.