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Incidence of Chlamydia pneumoniae infection in vertically HIV-1 infected children
R Cosentini1, S Esposito, F Blasi
1Department of Emergency Medicine, IRCCS Ospedale Maggiore Milano, Milan, Italy.
Insights
Chlamydia pneumoniae infections are more common in vertically HIV-1 infected children. Lower CD4+ counts and higher p24 antigen levels were linked to Chlamydia pneumoniae seroconversion in these children.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Virology
Background:
- Chlamydia pneumoniae is a common respiratory pathogen.
- Human Immunodeficiency Virus type 1 (HIV-1) infection impacts immune function, increasing susceptibility to infections.
- Respiratory tract infections (RTIs) are a significant cause of morbidity and mortality in vertically HIV-1 infected children.
Purpose of the Study:
- To investigate the seroconversion rate of Chlamydia pneumoniae antibodies in vertically HIV-1 infected children.
- To identify factors associated with Chlamydia pneumoniae seroconversion in this population.
- To explore the role of Chlamydia pneumoniae in RTIs among vertically HIV-1 infected children.
Main Methods:
- Analysis of blood samples from 26 vertically HIV-1 infected children and 14 seroreverter controls over 3 years.
- Serological testing for Chlamydia pneumoniae antibodies.
- Assessment of CD4+ cell counts and p24 antigen levels at enrollment.
- Correlation of seroconversion with clinical signs and symptoms of acute respiratory infection.
Main Results:
- Chlamydia pneumoniae seroconversion occurred in 13 of 26 (50%) vertically HIV-1 infected children, compared to 1 of 14 (7%) in the seroreverter group (P=0.013).
- Lower mean CD4+ cell count and positivity for p24 antigen at enrollment were significantly associated with Chlamydia pneumoniae seroconversion.
- Eight of the 13 HIV-1 infected children with seroconversion reported signs/symptoms of acute respiratory infection preceding sample collection.
Conclusions:
- Vertically HIV-1 infected children exhibit a higher rate of Chlamydia pneumoniae seroconversion.
- Immune status, indicated by CD4+ cell count and p24 antigen, influences Chlamydia pneumoniae susceptibility in HIV-1 infected children.
- Chlamydia pneumoniae may play a role in the pathogenesis of respiratory tract infections in vertically HIV-1 infected children.
Abstract:
The rate of seroconversion for antibody to Chlamydia pneumoniae was analysed in blood samples of 26 vertically HIV-1 infected children and 14 seroreverter children (HIV-negative children born to HIV-positive mothers) during a 3-year study period. Seroconversion for Chlamydia pneumoniae was found in 13 of 26 HIV-1 infected children and in 1 of 14 in the seroreverter group (P=0.013). A lower mean CD4+ cell count and p24 antigen positivity at enrolment were significantly associated with seroconversion for Chlamydia pneumoniae. Signs and symptoms of acute respiratory infection were recorded in the 30 to 40 days preceding collection of the blood samples showing seroconversion for Chlamydia pneumoniae in 8 of 13 HIV-1 infected children and in the single seroreverter. This study confirms the potential role of Chlamydia pneumoniae in the pathogenesis of respiratory tract infections in HIV-1 infected subjects.