CDC NATIONAL AIDS HOTLINE TRAINING BULLETIN #55 - June 23, 1993
Centers for Disease Control and Prevention

Of the 4,480 pediatric AIDS cases (<13 years of age) reported to CDC as of March 31, 1993, 3,887 (87%) occurred among children who acquired their infection perinatally (mother with/at risk for HIV infection), 509 (11%) occurred among children who acquired HIV through transfusion of blood/blood components or treatment for a coagulation disorder, and 84 (2%) occurred among children who had undetermined risk factors. All AIDS cases reported with an undetermined risk of HIV infection are followed-up by state/local health departments using standard public health investigation techniques. Pediatric cases without risk information are a high priority for follow-up. CDC provides technical assistance to state/local health departments for these follow-up investigations.

Of these 84 pediatric cases with undetermined risk, 74 (88%) were still being actively investigated and 10 were closed with incomplete information due to death (N=2), loss to follow-up (N=5), or refusal to participate in a standardized interview (N=3). State health departments report that for many of these cases, investigation is incomplete because many children were abandoned at birth or were in foster care and, thus, the mother's HIV infection status or risk information cannot be ascertained.

Of these 84 children, 16 (19%) were white, 51 (61%) were black, 17 (20%) were Hispanic. This breakdown by race is similar to that for pediatric cases reported with an identified risk. The average age at AIDS diagnosis was also similar for pediatric cases reported with and without risk (32 and 34 months, respectively).

The majority of pediatric cases reported without risk information are subsequently reclassified into identified transmission categories. As of March 31, 1993, 175 cases had been originally reported without risk information and subsequently reclassified as follows:

Hemophilia/coagulation disorder 2 ( 1%) Received transfusion* 7 ( 4%) Perinatal transmission 166 (95%)

* Includes 2 children who developed AIDS after receiving blood screened negative for HIV antibody.