Biggest Little Victims of Them All: Babies With AIDS Virus

Of all the AIDS victims, the most helpless are the babies.

Fourteen months ago at the UCI Medical Center, twins were born whose blood showed they had antibodies to the AIDS virus, passed to them by their mother.

While tests three months later showed that one twin, a boy, no longer had the antibodies, his sister continued to show evidence that she had been infected with the virus that preys on the body’s immune system.

The twins are not an isolated case. In the last 15 months, eight babies in Orange County have tested positive at birth to the AIDS virus antibodies, born to mothers who have been infected through prostitution, intravenous drug use or both, according to Dr. Jamieson Jones, a neontologist at UCI Medical Center who is tracking their cases.

None of the eight have contracted the disease, and later tests showed that three of them no longer had the antibodies.

Jones runs the hospital’s “special needs program,” which screens certain expectant mothers for AIDS exposure and then provides twice-monthly check-ups to the infants who have been infected with their mothers’ virus.

At the same time, the county’s Social Services Agency has provided special training to the families who are caring for the babies infected with the virus--to protect them against transmitting it and to prepare them for the infants’ special needs. It is the only such program for AIDS-infected babies in Southern California and has prompted inquiries by social services agencies from other parts of the country, according to county officials.

“This is one of the most progressive counties, when it comes to this,” Jones said of the county’s program. “Nothing is going to catch us by surprise.”

AIDS is transmitted most often through sexual intercourse, the sharing of contaminated hypodermic needles and blood transfusion. Mothers can pass the virus to fetuses in the womb.

While the incidence of babies born with the AIDS virus has not been as dramatic in Orange County and Southern California as it has on the East Coast, authorities are keeping strict tabs on the few tiny victims here.

Blood tests on the eight babies, performed three months after birth, revealed that three no longer had the antibodies--not unexpectedly, Jones said. Babies are normally born with their mothers’ antibodies to many diseases, which protect the infants during their fragile first months of life. Those antibodies naturally last for only a few months, he said.

But blood tests on the five remaining babies continued to reveal antibodies, which indicates the infants harbor the virus, he said.

However, even if babies with the virus don’t contract the disease, they still deserve special scrutiny because the virus can produce future medical problems, Jones said.

But beyond the immediate medical needs, many developmental problems don’t show up in children until they are at least 5 years old, he said. In addition, because the virus has led to cancers in adult AIDS patients, children who grow up with the virus may be at special risk for slow-developing illnesses, he said.

“We want to watch their milestones . . . What we’re trying to do is gather all this data now, follow them now, so when these kids are 5 or 13 or 30 we can see where they are,” Jones said.

Nationwide, 402 children had developed AIDS as of Nov. 24, and 240 had died of the syndrome, according to a county public health official. Those numbers don’t include children who have been infected with the virus but do not suffer the symptoms.

According to the latest statistics, the areas with the most cases of childhood AIDS are New York with 141; New Jersey, 60; Florida, 54, and Puerto Rico, 24. Two of California’s 22 cases have been from Orange County. One of the children acquired the disease through blood transfusions, the other from blood products as part of treatment for hemophilia, according to the county official. Both died.

About two-thirds of newborns nationwide who are delivered by women with the AIDS virus test positive for antibodies, Jones said. Half of those infants, when tested a few months later, no longer show signs of the antibodies, he said.

To keep on top of Orange County’s cases, Jones and other doctors at the medical center have, for the past year, routinely screened pregnant women who admit to being prostitutes or using intravenous drugs, activities which place them at risk for contracting the AIDS virus. Jones estimated about 15 women a month have been screened.

As for the babies, Jones holds a special clinic twice a month to check for problems that have been linked to the virus in children elsewhere, such as infection, failure to thrive, recurrent diarrhea or lymph node swelling. In addition, these children tend to develop with eyes too widely spaced, boxlike foreheads and widened nasal bridges, he said. So far, no virus-infected babies in Orange County have had severe problems with their immune systems or physical development, he said.

But in the case of the twins, the infected girl has been developing more slowly than her uninfected brother, he said. The boy began walking at 11 months; his sister followed suit three months later.

Jones and county officials declined to give details about the twins or any other babies exposed to AIDS, citing confidentiality laws.

Because mothers with the AIDS virus are usually deemed unfit to care for their babies, due to their drug use, prostitution or behavioral history, the babies exposed to AIDS are placed with relatives or foster families who have been trained to deal with the children’s special needs.

The county Social Services Agency trains the families to exercise hygiene procedures to guard against transmission of the AIDS virus, which cannot be spread through casual contact.

The program was developed at the urging of the Foster Parents Assn. of Orange County, said Tuey Lee, program manager for children’s services at the agency.

So far, the county has trained only two licensed foster families to care for AIDS-infected babies and is eager to recruit more, even though their services are not currently needed.

“We hope we never need to use them,” said Barbara Matthews, supervisor of the home care and foster care program. The families who have volunteered for the program “are good families, people who are genuinely concerned about these children and not caught up in the ‘Gee, I’ll catch it if they breathe on me’ hysteria,” she said.

Other counties, if they know that a baby has tested positive for AIDS exposure, keep the infants in hospitals or institutions, which is not as good an environment as a family home, she said. “Kids thrive when they are nurtured, and these babies are no different.”

The UCI doctors prefer to test the high-risk mothers early in their pregnancies, Jones said. If an expectant mother is found to have the AIDS virus early enough, he said, the U.S. Centers for Disease Control recommends a therapeutic abortion. But doctors often don’t know until the woman is close to delivery.

“A lot of times (intravenous) drug users do not have the best in prenatal care,” he said. Even if the mother does not admit to drug use, or if the doctors do not notice needle “tracks” on her arms, there is usually a giveaway--she bears a baby born addicted to drugs, he said.

“I don’t know if we’re seeing them all. I don’t know how many we don’t test. I don’t know how many don’t admit to prostitution,” Jones said. But the UCI program is creating a mechanism for monitoring intravenous-drug-using and prostitute mothers and their babies that could be invaluable if the number of AIDS cases mushrooms in the future, he said.

“We’re just trying to create a program so that it’s already set up when it needs to be,” Jones said. “I don’t think this is a problem to ignore.”