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December 1991

A Third Pattern of Disease Progression in Children Infected With Human Immunodeficiency Virus

Author Affiliations

Yale University School of Medicine Department of Pediatrics 333 Cedar St New Haven, CT 06510-8064

Am J Dis Child. 1991;145(12):1348-1349. doi:10.1001/archpedi.1991.02160120016006

Sir.—We read with interest the article by Blanche et al1 on infants with perinatally acquired human immunodeficiency virus (HIV) infection. We too have noted a bimodal pattern of HIV-related disease in our pediatric patients with acquired immunodeficiency syndrome (AIDS).2 In the last few years we have become aware of a third pattern of HIV infection in children, namely, severe manifestations of disease early in life that lessen over the next 5 to 10 years without antiretroviral therapy. This pattern is illustrated in the following patient reports of three HIV-infected children born to drug-abusing mothers.

Patient Reports.—PATIENT 1.—A 10-year-old black twin boy was born be tween 34 and 36 weeks' gestation. He weighed 1520 g at birth. His Apgar scores were 8/9 at 1 and 5 minutes. The boy had an uncomplicated neonatal course and was discharged after 2 weeks weighing 1950 g. Within his first 10

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