VIENNA — Uninfected children born to HIV-positive mothers showed a reassuring absence of impaired immune function at 15 months, both quantitatively and qualitatively, in a case-control study.
This finding, if confirmed, would have major implications for health care resource allocation in light of the growing number of uninfected children with HIV-positive mothers worldwide, Dr. Lilian Kolte noted at the meeting.
She reported on 20 HIV-exposed but uninfected 15-month-old children of HIV-positive mothers and 10 age- and sex-matched controls, all of whom had comprehensive immunologic evaluation.
The study was undertaken because uninfected children born to HIV-infected mothers typically have low CD4 counts, reduced thymic output, and other immunologic abnormalities at birth. This raises a key question: Do the deficits persist beyond infancy?
The answer provided by this study is “no.” The immune deficits present at birth in these children are not long term, according to Dr. Kolte of Copenhagen University Hospital.
Thymic output as determined by polymerase chain reaction measurement of CD4+ cells containing T-cell receptor excision circles did not differ at age 15 months between the HIV-exposed and control children. Neither did total and naive CD4 and CD8 counts. Levels of Haemophilus influenzae type B protective antibodies in response to vaccination were comparable in the two groups.
Moreover, levels of the cytokines interleukin-1B, −2, −4, −6, −8, and −10; transforming growth factor–beta; and interferon-gamma were similar in the two groups of children as well. Thymic size as estimated by ultrasound was about one-third less in the HIV-exposed group. However, the two groups of children were similar in terms of birth weight as well as height and weight at age 15 months.
Disclosures: Dr. Kolte reported no conflicts of interest.