About 25% of the children of untreated HIV-infected mothers are later
determined to be HIV-infected. At birth, all of the children of HIV-in
fected mothers have HIV-IgG antibody, which is transferred transplacen
tally from the mothers to their children, and infected children produc
e HIV-IgG antibody in response to their infection. Most infected child
ren have detectable HIV-IgA by 3 months of age. We have studied HIV an
tibody responses in three groups of children of HIV-infected mothers a
t 9 to 12 months and 15 to 24 months of age. The groups were classifie
d by Centers for Disease Control and Prevention (CDC) criteria and inc
luded: (I) HIV seroreverters (SR); (II) HIV-infected; Non- to mildly s
ymptomatic (N+A); and (III) HIV-infected; Moderately to Severely Sympt
omatic (BSC). HIV-IgG antibody was detected in some SR children at low
titer levels (10 to 20) through 11 months of age but not at 12 or lat
er. For both the N+A and B+C groups, there were no significant changes
in the mean HIV-IgG titers from 9-12 to 15-24 months of age. Also, no
significant difference in titers were found between the two infected
groups for both age groups. HIV-IgA antibody responses were more frequ
ently positive at 15 to 24 months for all seven antigens studied for t
he N+A than the B+C patients; however, statistical significance was at
tained only for gp41 (p less than or equal to 0.01). N+A children show
ed more responses to the viral antigens at 15-24 months than at 9-12 m
onths. This increase in HIV-specific IgA among the N+A children may be
important in restricting their HIV infections. Total IgG levels were
significantly higher in the HIV-infected groups than in the SR (p less
than or equal to 0.0001), but no differences were detected between sh
e N+A and B+C groups. Total IgA increased over lime in the N+A patient
s from 9-12 to 15-24 months. A similar trend was apparent in the B+C g
roup, but did not reach statistical significance, Both N+A and B+C pat
ients at 15-24 months had significantly higher total IgA levels than d
id the SR at 9-12 months of age. The B+C group had significantly lower
CD4 counts for both age groups than did the N+A or SR groups (p less
than or equal to 0.0001).