Early-treated children with perinatal HIV show elevated monocyte activation into late childhood

Area of Science:

• Immunology
• Pediatric Infectious Diseases
• HIV/AIDS Research

Background:

• Early antiretroviral therapy (ART) initiation in children with perinatal HIV (CHIV) is crucial for long-term health.
• The long-term inflammatory profile of CHIV on early ART remains incompletely understood.
• Understanding chronic inflammation is key to managing non-communicable disease risks in this population.

Purpose of the Study:

• To compare the long-term inflammatory profiles of CHIV with early ART initiation against HIV-unexposed children.
• To identify specific inflammatory markers associated with perinatal HIV infection and early treatment.
• To assess the implications of persistent inflammation for non-communicable disease risk in CHIV.

Main Methods:

• Longitudinal study design.
• Comparison of 26 inflammatory markers between CHIV and HIV-unexposed children.
• Analysis of immune marker elevations, focusing on monocyte activation.

Main Results:

• CHIV demonstrated widespread elevations in inflammatory markers compared to controls.
• Elevated markers were predominantly associated with monocyte activation pathways.
• These inflammatory changes persisted despite early ART and sustained viral suppression.

Conclusions:

• Early ART initiation in CHIV does not fully resolve long-term immune activation.
• Persistent monocyte activation in CHIV suggests an ongoing inflammatory state.
• CHIV remain at an elevated risk for non-communicable diseases due to chronic inflammation.