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Hersh Bradley S.; Popovici, Florin; Jezek, Zdenek; Satten, Glen A.; Apetrei, Roxana C.; Beldescu, Nicolae; George, J Richard; Shapiro, Craig N.; Gayle, Helene D.; Heymann, David L.
Original Papers: Epidemiology and Social: PDF Only

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 children between 0 and 4 years of age living in an orphanage. Orphanage and hospital 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 HIV-positive children; one HIV-negative control, matched by age, was selected for each case.

Results:Overall, 20 (20%) children were HIV-positive, 88 (87%) tested positive for antibody to hepatitis B core antigen, and 32 (32%) were hepatitis B surface antigen-positive. In the case–control study, HIV-positive children had received more therapeutic injections [mean, 280; median, 231 ] than age-matched HIV-negative children [mean; 142, median, 155; P=0.02]. Cases were more likely than controls to have received over 200 lifetime injections (odds ratio, 5.7; 95% confidence interval, 1.2–32.7). Blood transfusions and mother-to-child transmission were excluded as routes of HIV transmission. By reviewing sterilization records and interviewing local health-care workers, we determined that needles and syringes were often re-used without proper disinfection in the orphanage.

Conclusions:These data provide strong epidemiologic evidence that indiscriminate injections with contaminated needles and syringes were responsible for HIV transmission in this population.

AIDS 1993, 7:1617–1624

© Lippincott-Raven Publishers.