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Preserved immune system in long-term asymptomatic vertically HIV-1 infected children

S Resino1, R Correa, J M Bellón

  • 1Laboratory of Immno-Molecular Biology, General University Hospital 'Gregorio Marañón', Madrid, Spain.

Insights

Long-term asymptomatic HIV-1 infected children maintain a preserved immune system, similar to controls, despite prolonged infection. New markers like TRECs and IL-7 can monitor disease progression in HIV.

Area of Science:

  • Immunology
  • Virology
  • Pediatrics

Background:

  • Human Immunodeficiency Virus type 1 (HIV-1) infection can lead to varied clinical outcomes in children.
  • Long-term asymptomatic (LTA) status in HIV-1 infected children suggests a preserved immune system, but requires detailed characterization.
  • Understanding immune status in LTA children is crucial for monitoring disease and identifying potential biomarkers.

Purpose of the Study:

  • To investigate the immune system status of long-term asymptomatic (LTA) HIV-1 infected children.
  • To compare immune parameters between LTA children, rapid progressor (RP) HIV-1 infected children, and healthy controls.
  • To identify potential biomarkers for monitoring HIV disease progression.

Main Methods:

  • Cross-sectional study of HIV-1 infected children (>7 years) categorized as LTA or RP, compared to uninfected controls.
  • Flow cytometry used to characterize CD4+ T-cell subsets (memory, naive, activation markers).
  • Assessed T-cell proliferative responses, cytokine production (TNF-alpha, IFN-gamma), serum IL-7 levels, and thymic T-cell production (TRECs).

Main Results:

  • LTA children exhibited preserved T-cell proliferative responses and cytokine production (TNF-alpha, IFN-gamma) compared to RP children, similar to controls.
  • LTA children showed distinct CD4+ T-cell subset profiles: lower memory cells, higher naive cells, and increased activation markers (HLA-DR, CD38) compared to controls.
  • Near-normal TRECs and IL-7 levels were observed in LTA children, contrasting with lower levels in RP children, with an inverse correlation between TRECs and IL-7.

Conclusions:

  • Asymptomatic HIV-1 infected children demonstrate a well-preserved immune system, comparable to uninfected children, even after over 7 years of infection.
  • CD4+ T-cell subset analysis reveals specific patterns in LTA children, indicating immune adaptation.
  • TRECs and IL-7 levels emerge as potential novel biomarkers for monitoring HIV disease status in children.

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