Association of Selected Phenotypic Markers of Lymphocyte Activation and Differentiation with Perinatal Human Immunodeficiency Virus Transmission and Infant Infection

Lambert, John S.; Moye, John; Plaeger, Susan; Stiehm, E. Richard; Bethel, James; Mofenson, Lynne; Mathieson, Bonnie J.; Kagan, Jonathan; Rosenblatt, Howard M.; Paxton, Helene; Suter, H; Landay, Alan

doi:10.1128/cdli.12.5.622-631.2005

Cited by 7 publications

(7 citation statements)

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“…It is very well known that HIV‐1 infection is associated with increased CD8 T cell numbers and increased expression of CD38 and HLA‐DR on T cells. A few reports have earlier shown similar alterations in CD8 T cells in normal pregnant women 4,7 . Consistent to that we observed activated CD8 T‐cell subsets being the highest in HIV‐1‐infected pregnant women.…”

Section: Discussionsupporting

confidence: 92%

“…There has been evidence of increased peripheral immune activation along with increased expression of some pro‐inflammatory cytokines during HIV‐1 infection and pregnancy 2,5–8 . These cytokines, along with growth factors, hormones and chemokines, circulate in the placental and peripheral blood compartments affecting the immunovirologic status of the HIV‐1‐infected pregnant women.…”

Section: Introductionmentioning

confidence: 99%

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ORIGINAL ARTICLE: Analysis of Immunological Markers Associated with Pregnancy and HIV‐1 Infection: Relevance in Perinatal Transmission in HIV‐1‐Infected Pregnant Women with Low Plasma Viral Load

Sachdeva

Oshima

Cotter

et al. 2008

American J Rep Immunol

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

ORIGINAL ARTICLE: Analysis of Immunological Markers Associated with Pregnancy and HIV‐1 Infection: Relevance in Perinatal Transmission in HIV‐1‐Infected Pregnant Women with Low Plasma Viral Load

Sachdeva

Oshima

Cotter

et al. 2008

American J Rep Immunol

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“…In the same way that HIV-infected children who respond to HAART increase the naive subset of T cells (34)(35)(36), it is possible that no further HIV exposure after birth might lead to reduction in the proportion of central memory CD4+ and CD8+ T cells and, as a consequence, an increase in naive T cells in children born to HIV-1-infected mothers. However, it is not possible to clearly ascertain whether some abnormalities have resulted from the antiretroviral drug exposure during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Imbalance of naive and memory T lymphocytes with sustained high cellular activation during the first year of life from uninfected children born to HIV-1-infected mothers on HAART

Ono

Santos

Succi

et al. 2008

Braz J Med Biol Res

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The immune consequences of in utero HIV exposure to uninfected children whose mothers were submitted to highly active antiretroviral therapy (HAART) during gestation are not well defined. We evaluated 45 HIV-exposed uninfected (ENI) neonates and 45 healthy unexposed control (CT) neonates. All HIV-infected mothers received HAART during pregnancy, and the viral load at delivery was <50 copies/mL for 56.8%. Twenty-three ENI neonates were further evaluated after 12 months and compared to 23 unexposed healthy age-matched infants. Immunophenotyping was performed by flow cytometry in cord and peripheral blood. Cord blood lymphocyte numbers did not differ between groups. However, ENI neonates had a lower percentage of naive T cells than CT neonates (CD4+, 76.6 vs 83.1%, P < 0.001; CD8+, 70.9 vs 79.6%, P = 0.003) and higher percentages of central memory T cells than CT neonates (CD4+, 13.9 vs 8.7%, P < 0.001; CD8+, 8.6 vs 4.8%, P = 0.001). CD38 mean fluorescence intensity of T cells was higher in ENI neonates (CD4+, 62.2 vs 52.1, P = 0.007; CD8+, 47.7 vs 35.3, P < 0.001). At 12 months, ENI infants still had higher mean fluorescence intensity of CD38 on T cells (CD4+, 34.2 vs 23.3, P < 0.001; CD8+, 26.8 vs 19.4, P = 0.035). Despite effective maternal virologic control at delivery, HIV-exposed uninfected children were born with lower levels of naive T cells. Immune activation was present at birth and remained until at least 12 months of age, suggesting that in utero exposure to HIV causes subtle immune abnormalities.

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“…For example, HIV-1-uninfected infants have higher CD3 ϩ , CD4 ϩ , and naive CD4 ϩ Tlymphocyte counts, whereas HIV-1-infected infants have higher total CD8 ϩ , CD8DR ϩ , CD45RA-DR ϩ , and CD28-DR ϩ T-lymphocyte counts. 44 Also, total IgG, IgA, and IgM concentrations are significantly higher among HIV-1-infected children than among HIV-1-uninfected children, although individual HIV-1-infected children may have normal concentrations. 38 …”

Section: Immune System Deterioration As a Consequence Of Hiv-1 Infectionmentioning

confidence: 98%

Diagnosis of HIV-1 Infection in Children Younger Than 18 Months in the United States

Read¹

2007

Pediatrics

120

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The objectives of this technical report are to describe methods of diagnosis of HIV-1 infection in children younger than 18 months in the United States and to review important issues that must be considered by clinicians who care for infants and young children born to HIV-1–infected women. Appropriate HIV-1 diagnostic testing for infants and children younger than 18 months differs from that for older children, adolescents, and adults because of passively transferred maternal HIV-1 antibodies, which may be detectable in the child's bloodstream until 18 months of age. Therefore, routine serologic testing of these infants and young children is generally only informative before the age of 18 months if the test result is negative. Virologic assays, including HIV-1 DNA or RNA assays, represent the gold standard for diagnostic testing of infants and children younger than 18 months. With such testing, the diagnosis of HIV-1 infection (as well as the presumptive exclusion of HIV-1 infection) can be established within the first several weeks of life among nonbreastfed infants. Important factors that must be considered when selecting HIV-1 diagnostic assays for pediatric patients and when choosing the timing of such assays include the age of the child, potential timing of infection of the child, whether the infection status of the child's mother is known or unknown, the antiretroviral exposure history of the mother and of the child, and characteristics of the virus. If the mother's HIV-1 serostatus is unknown, rapid HIV-1 antibody testing of the newborn infant to identify HIV-1 exposure is essential so that antiretroviral prophylaxis can be initiated within the first 12 hours of life if test results are positive. For HIV-1–exposed infants (identified by positive maternal test results or positive antibody results for the infant shortly after birth), it has been recommended that diagnostic testing with HIV-1 DNA or RNA assays be performed within the first 14 days of life, at 1 to 2 months of age, and at 3 to 6 months of age. If any of these test results are positive, repeat testing is recommended to confirm the diagnosis of HIV-1 infection. A diagnosis of HIV-1 infection can be made on the basis of 2 positive HIV-1 DNA or RNA assay results. In nonbreastfeeding children younger than 18 months with no positive HIV-1 virologic test results, presumptive exclusion of HIV-1 infection can be based on 2 negative virologic test results (1 obtained at ≥2 weeks and 1 obtained at ≥4 weeks of age); 1 negative virologic test result obtained at ≥8 weeks of age; or 1 negative HIV-1 antibody test result obtained at ≥6 months of age. Alternatively, presumptive exclusion of HIV-1 infection can be based on 1 positive HIV-1 virologic test with at least 2 subsequent negative virologic test results (at least 1 of which is performed at ≥8 weeks of age) or negative HIV-1 antibody test results (at least 1 of which is performed at ≥6 months of age). Definitive exclusion of HIV-1 infection is based on 2 negative virologic test results, 1 obtained at ≥1 month of age and 1 obtained at ≥4 months of age, or 2 negative HIV-1 antibody test results from separate specimens obtained at ≥6 months of age. For both presumptive and definitive exclusion of infection, the child should have no other laboratory (eg, no positive virologic test results) or clinical (eg, no AIDS-defining conditions) evidence of HIV-1 infection. Many clinicians confirm the absence of HIV-1 infection with a negative HIV-1 antibody assay result at 12 to 18 months of age. For breastfeeding infants, a similar testing algorithm can be followed, with timing of testing starting from the date of complete cessation of breastfeeding instead of the date of birth.

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Association of Selected Phenotypic Markers of Lymphocyte Activation and Differentiation with Perinatal Human Immunodeficiency Virus Transmission and Infant Infection

Cited by 7 publications

References 37 publications

ORIGINAL ARTICLE: Analysis of Immunological Markers Associated with Pregnancy and HIV‐1 Infection: Relevance in Perinatal Transmission in HIV‐1‐Infected Pregnant Women with Low Plasma Viral Load

ORIGINAL ARTICLE: Analysis of Immunological Markers Associated with Pregnancy and HIV‐1 Infection: Relevance in Perinatal Transmission in HIV‐1‐Infected Pregnant Women with Low Plasma Viral Load

Imbalance of naive and memory T lymphocytes with sustained high cellular activation during the first year of life from uninfected children born to HIV-1-infected mothers on HAART

Diagnosis of HIV-1 Infection in Children Younger Than 18 Months in the United States

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