GP204 HIV infection in children with perinatal transmission: clinical and immunological features. (June 2019)

• Record Type: Journal Article
• Authors: Moskaleva, Ekaterina; Petrova, Alla; Smirova, Svetlana; Rychkova, Lyubov; Vanyarkina, Anastasiya
• Is Part Of: Archives of disease in childhood. Volume 104:(2019)Supplement 3
• Page Start: A113
• Page End: A113
• Publication Date: 2019-06
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2019-epa.263
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Introduction: HIV infection is more rapid and serious in children with perinatal transmission. As the immune system is progressively deteriorating, the aim was to study parameters of the immune system, which is necessary to determine disease approach and prognosis. Methods: We conducted a cross-sectional randomized study of children aged 1 to 5 years: 32 children with perinatal HIV infection (main group), and 28 healthy children. Criteria for inclusion in main group: confirmed HIV infection, clinical stages 2–3 (WHO classification, 2006). Exclusion criterion is parents' refusal to participate. Clinical examination of children was conducted. We estimated the frequency of clinical manifestations of immunodeficiency syndromes (Pabs /P%), and analyzed parameters of the immune status. The pattern of lymphocyte subpopulations was assessed by laser flow cytometry, immunoglobulins and interleukins concentrations were determined by EIA. A comparative analysis was performed using non-parametric Mann-Whitney U-test. Results: Regardless of clinical stage, all children with HIV infection showed delay in physical and neuropsychic development, CNS damage, Banti's syndrome, bulky lymphadenopathy, recurrent bacterial infections of upper respiratory tract. Frequent manifestations of HIV infection are anemia of 90.5±3.7%, and repeated pneumonia from 2 to 6 times a year (71.4±5.7%). Immunity disorders manifested themselves in all HIV-infected children. Infectious and lymphoproliferative syndromes have the most intensive manifestation and are found in 100% of the HIV-infected. Infections target organs and systems, functioning as a barrier and participating in immunogenesis. Combined damage to the immune system was detected. The state of cellular immunity was characterized by decreased numbers of CD3+ lymphocytes (55.3±7.05%; p<0.01), CD4+ lymphocytes (26.15±5.6%; p<0.001), and increased absolute (0.07±0.01; p<0.01) and relative (1.7±0.9×10 9 /l; p<0.001) numbers of NK cells. Changes in humoral immune response were expressed by a significant increase in concentration of serum IgA (1.14±0.51 g/l), IgM (2.59±1.51 g/l, IgG (22.17±2.2 g/l), and circulating immune complexes by 2–4 times in comparison with the healthy children. Study of serum concentrations of INF-γ, IL-4, IL-1, IL-8 in children with HIV infection revealed a significant increase in INF-γ, and a decrease in IL-4, IL-1, IL-8 in comparison with healthy group. Conclusions: We revealed signs of the immune system impairment in children with perinatal HIV infection: clinical - manifestations of infectious and lymphoproliferative syndromes, and laboratory - combined immunodeficiency. HIV-infected children had an immune deviation towards Th2 response: increased IL-4 concentration and total IgE, and decreased INF-γ in serum.