Pediatric acquired immunodeficiency syndrome: an unusually high incidence of twinning

Since the first case of AIDS in a child was reported to the New York City Department of Health in 1982, there have been 672 cases of AIDS diagnosed in children younger than 13 years of age, accounting for 2.4 percent of the AIDS cases in New York City. Ninety-five percent of AIDS-afflicted children contracted the disease from their mothers. The mother was an intravenous drug user in 60 percent of cases, or had sexual contact with an intravenous drug user in 20 percent of cases. Of 235 cases of AIDS in children who contracted it from their mothers, 13 AIDS patients belonged to 10 sets of twins. This is considered a surprisingly high rate of twin births. Three cases in which only one twin was afflicted with AIDS have been previously described. Some possible explanations for the greater incidence of twins among pediatric AIDS cases include: a greater incidence of twins among AIDS-afflicted women who use narcotics; the ability of the human immunodeficiency virus (HIV), which causes AIDS, to increase the frequency of twin births; increased susceptibility of twins to HIV infection; and stresses, such as low birth weight and competition for nutrients, experienced by twins in utero and after birth that may predispose to developing HIV infection. Further studies are needed to clarify whether twin births are more prevalent among HIV-infected women because of drug use or other factors; whether twins are more susceptible to HIV infection than infants born singly; and whether twins have a more severe prognosis when they develop HIV infection. (Consumer Summary produced by Reliance Medical Information, Inc.)