RISK-FACTORS FOR HIV-INFECTION AMONG ABANDONED ROMANIAN CHILDREN

Objective: To determine risk factors for HIV infection among abandoned Romanian infants and children living in a public institution. Methods : A cross-sectional study was conducted in June 1990 among 101 childre n between 0 and 4 years of age living in an orphanage. Orphanage and h ospital records were reviewed and a blood specimen for hepatitis B and HIV serologic testing obtained from each child. A case-control study was conducted using data from the cross-sectional study. Cases were HI V-positive children; one HIV-negative control, matched by age, was sel ected for each case. Results: Overall, 20 (20%) children were HIV-posi tive, 88 (87%) tested positive for antibody to hepatitis B core antige n, and 32 (32%) were hepatitis B surface antigen-positive. In the case -control study, HIV-positive children had received more therapeutic in jections [mean, 280; median, 231] than age-matched HIV-negative childr en [mean; 142, median, 155; P=0.02]. Cases were more likely than contr ols to have received over 200 lifetime injections (odds ratio, 5.7; 95 % confidence interval, 1.2-32.7). Blood transfusions and mother-to-chi ld transmission were excluded as routes of HIV transmission. By review ing sterilization records and interviewing local health-care workers, we determined that needles and syringes were often re-used without pro per disinfection in the orphanage. Conclusions: These data provide str ong epidemiologic evidence that indiscriminate injections with contami nated needles and syringes were responsible for HIV transmission in th is population.