Premium
Increased monocyte activation with age among HIV ‐infected long term non‐progressor children: implications for early treatment initiation
Author(s) -
D'Souza RR,
Gopalan BP,
Rajnala N,
Phetsouphanh C,
Shet A
Publication year - 2019
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12751
Subject(s) - medicine , monocyte , term (time) , human immunodeficiency virus (hiv) , immunology , quantum mechanics , physics
Objectives The key to newer therapeutic and eradication approaches often lies in understanding slow disease progression in HIV infection. The paediatric population has been poorly studied in this regard. We aimed to describe a cohort of perinatally infected long‐term nonprogressor ( LTNP ) children living with HIV in India and to evaluate the immune biomarkers of disease progression. Methods LTNPs ( ART ‐naïve, with a CD 4 count ≥ 500 cells/μL at age ≥ 7 years) among the cohort of HIV ‐infected children were identified and monitored longitudinally, and their CD 4 T‐cell counts and plasma viral loads were measured every 6 months. The plasma monocyte/macrophage activation markers, namely soluble CD14 ( sCD 14), soluble CD163 (sCD163) and interferon‐inducible protein‐10 ( IP ‐10) were measured by enzyme‐linked immunosorbent assay ( ELISA ) in LTNP s and progressors. The Mann–Whitney U ‐test was used to compare the two groups and P values < 0.05 were considered statistically significant. Spearman's rank or Pearson's correlation coefficient ( r ) was calculated to determine the associations between variables. Results Among 378 children living with HIV ‐1 surveyed in our cohort, 40 (10.6%) were LTNP s. Longitudinal analysis of the LTNP data showed that both CD 4 count and viral load declined significantly with age ( P < 0.0001 for both). Plasma sCD 14 levels were significantly ( P < 0.005) higher in progressors and sCD 163 levels were significantly ( P < 0.0001) higher in LTNP s. Conclusions The prevalence of LTNP s in our cohort of perinatally infected children living with HIV was 10.6%. We observed a trend for associations between the increasing sCD 163 monocyte/macrophage activation marker levels, declining CD 4 counts and the gradual loss of nonprogressor status with age in the LTNP s. These findings underscore the need for early antiretroviral therapy in those children with proven slow disease progression.