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Early immunological predictors of neurodevelopmental outcomes in HIV-infected children

Jutarat Mekmullica1, Pim Brouwers, Manhattan Charurat

  • 1Division of Infectious Diseases, Children's Hospital Boston, Boston, Massachusetts 02115, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|January 1, 2009
PubMed

Insights

Low immune activation in early life, indicated by CD8(+)HLA-DR(+) cells, is linked to better neurodevelopment in children with human immunodeficiency virus (HIV). This finding suggests immune markers can predict developmental outcomes in HIV-infected infants.

Area of Science:

  • Pediatric Immunology
  • Neurodevelopmental Pediatrics
  • Infectious Diseases

Background:

  • Previous studies linked low activated CD8(+) T lymphocytes in early infancy to better immunological prognosis in children with human immunodeficiency virus (HIV).
  • This study aimed to investigate the association between early immune activation and neurodevelopmental outcomes in HIV-infected children.

Purpose of the Study:

  • To determine if early immune activation in HIV-infected children predicts neurodevelopmental prognosis.
  • To examine the relationship between specific immune cell activation markers and cognitive and psychomotor development.

Main Methods:

  • Ninety-eight HIV-infected children with available flow cytometry data (first 2 months) and neurodevelopmental testing (up to 30 months) were analyzed.
  • Children were categorized based on immune activation levels (CD8(+)HLA-DR(+) and CD8(+)CD38(+) cells).
  • Statistical analyses included survival analysis, Cox regression, and longitudinal regression models.

Main Results:

  • A low percentage of CD8(+)HLA-DR(+) cells (
  • This association remained significant after adjusting for CD4 count, viral load, and AIDS progression.
  • A similar, though less significant, association was observed for mental development, while CD8(+)CD38(+) cell levels did not show a significant link to neurodevelopmental outcomes.

Conclusions:

  • Low immune activation, specifically a low percentage of CD8(+)HLA-DR(+) cells, in early infancy is a favorable predictor of psychomotor and mental development in children with HIV.
  • This immune marker's predictive value is independent of other indicators of HIV severity and disease progression.
Abstract

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