PEDIATRICS Vol. 88 No. 2 August 1991, pp. 242-249
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Risk of Human Immunodeficiency Virus Type 1 Infection Among Sexual and Nonsexual Household Contacts of Persons With Congenital Clotting Disorders

Jeanne M. Lusher MD1, Eva A. Operskalski PhD2, Hang Lee MS2, James W. Mosley MD2, Louis M. Aledort MD3, Shelby L. Dietrich MD4, George F. Gjerset MD5, Margaret W. Hilgartner MD6, Marion A. Koerper MD7, and Charles H. Pegelow MD8

1 From Wayne State University, Detroit, Michigan
2 From the University of Southern California, Los Angeles, California
3 From Mount Sinai Medical Center, New York
4 Huntington Memorial Hospital, Pasadena, California
5 Puget Sound Blood Center, Seattle, Washington
6 Cornell University Medical College, New York, New York
7 From the University of California, San Francisco, California
8 From the University of Miami, Florida

The status of human immunodeficiency virus type 1 (HIV-1) infection at the time of transmission to sexual contacts remains poorly defined. Transmission to nonsexual household contacts has appeared to be rare. A total of 505 sexual and nonsexual contacts of HIV-1-infected hemophiliacs in 349 households was observed. At entry, 10% of 201 sexual partners were anti-HIV-1-positive. Follow-up of 151 uninfected partners during a total of 351 person-years of observation showed no seroconversions, although there were 13 pregnancies during that period. Eighty-seven percent of the seronegative respondents to a detailed questionnaire reported unprotected sexual contact at least occasionally. Among 304 other household members, including 108 parents who helped administer clotting factor concentrates to their children, none was seropositive at entry. Follow-up of 263 showed no seroconversions during a total of 605 person-years of observation. Thus, anti-HIV-1-positive hemophiliacs transmitted to their partners earlier in their course but were not found to do so when prospectively observed. No relationship to level of viremia as indicated by CD4 count, HIV-1 p24 antigenemia, or acquired immunodeficiency syndrome was found. Anti-HIV-1-positive hemophiliacs had not transmitted to their nonsexual household contacts before study entry and did not do so subsequently, indicating that the risk from even close nonsexual contact is extremely low.

Key Words: human immunodeficiency virus type 1 • household transmission • sexual transmission • hemophilia • surveillance • epidemiologic studies

Submitted on April 23, 1990
Accepted on July 11, 1990




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