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Evidence for Both Symptomatic and Asymptomatic Carriers

Gwendolyn B. Scott, MD; Margaret A. Fischl, MD; Nancy Klimas, MD; Mary Ann Fletcher, PhD; Gordon M. Dickinson, MD; Robert S. Levine, MD; Wade P. Parks, PhD, MD

JAMA. 1985;253(3):363-366.

Abstract
Sixteen mothers of 22 infants with the acquired immunodeficiency syndrome (AIDS) or AIDS-related complex were followed up for evidence of clinical and immunologic abnormalities. With one exception, all mothers were clinically well at delivery but had evidence of immune dysfunction, with T-cell abnormalities and inverted T4/T8 ratios and/or elevation of serum immunoglobulin levels, particularly of IgG. During a follow-up period that averaged 30 months, AIDS developed in five of the mothers and AIDS-related complex in seven. Twelve subsequent pregnancies in 11 mothers produced four affected infants, suggesting that mothers can be persistently infected. Six mothers were delivered of subsequent infants who remain unaffected. These results suggest that the mothers are the likely source of infection in non—transfusion-associated cases of AIDS or AIDS-related complex in infants, that mothers have persistent immunologic abnormalities, and that they are at increased risk of developing AIDS or AIDS-related complex.

(JAMA 1985;253:363-366)

Author Affiliations
From the Departments of Pediatrics (Drs Scott, Levine, and Parks), Medicine (Drs Fischl, Klimas, Fletcher, and Dickinson), Microbiology and Immunology (Drs Fletcher and Parks), and Epidemiology (Dr Levine), Division of Immunology and Infectious Diseases, University of Miami School of Medicine.

Footnotes
Reprint requests to Department of Pediatrics (R-131), University of Miami School of Medicine, PO Box 016960, Miami, FL 33101 (Dr Scott).

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