Impact of maternal HIV-1 viremia on lymphocyte subsets among HIV-exposed uninfected infants: protective mechanism or immunodeficiency

• Published in: BMC infectious diseases 2014-05, Vol.14 (1), p.236-236, Article 236
• Main Authors: Kakkar, Fatima, Lamarre, Valerie, Ducruet, Thierry, Boucher, Marc, Valois, Silvie, Soudeyns, Hugo, Lapointe, Normand
• Format: Article
• Language: English
• Subjects: Adult; Analysis; CD4 Lymphocyte Count; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Comparative analysis; Enriched uranium; Female; Health aspects; HIV; HIV Infections - immunology; HIV Infections - virology; HIV Seropositivity; HIV-1 - immunology; Human immunodeficiency virus; Human immunodeficiency virus 1; Humans; Immune system; Infant; Infant, Newborn - immunology; Infectious Disease Transmission, Vertical; Lymphocyte Subsets - immunology; Male; Mortality; Mothers; Physiological aspects; Pregnancy; Pregnancy Complications, Infectious - immunology; Pregnancy Complications, Infectious - virology; Pregnant women; Viral Load; Viremia - immunology; Viremia - virology; Womens health
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/1471-2334-14-236

Reports of increased morbidity and mortality from infectious diseases among HIV Exposed Uninfected (HEU) infants have raised concern about a possible underlying immunodeficiency among them. The objective of this study was to assess the immunological profile of HEU infants born to mothers exhibiting different levels of HIV-1 viremia at the time of delivery. Study subjects were enrolled in the Centre maternel et infantile sur le SIDA (CMIS) mother-child cohort between 1997 and 2010 (n =585). Infant CD4+ T cell, CD8+ T cell and CD19+ B cell counts were assessed at 2 and 6 months of age, and compared among HEU infants in groups defined by maternal viral load (VL) at the time of delivery (VL  1000 copies/ml) in a multivariable analysis. At 2 months of age, infants born to mothers with VL > 1000 copies/ml had lower CD4+ T cell counts compared to those born to mothers with VL  1000 copies/ml. These results suggest that exposure to high levels of HIV-1 viremia in utero, even in the absence of perinatal transmission, may affect the infant's developing immune system. While further work needs to be done to confirm these findings, they reinforce the need for optimal treatment of HIV infected pregnant women, and careful follow-up of HEU infants.