Increased microbial translocation in ≤180 days old perinatally human immunodeficiency virus-positive infants as compared with human immunodeficiency virus-exposed uninfected infants of similar age
Date
2011
Authors
Papasavvas E.
Azzoni L.
Foulkes A.
Violari A.
Cotton M.F.
Pistilli M.
Reynolds G.
Yin X.
Glencross D.K.
Stevens W.S.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
BACKGROUND: The effect of early versus deferred antiretroviral treatment (ART) on plasma concentration of lipopolysaccharide (LPS) and host LPS-binding molecules in human immunodeficiency virus (HIV)-infected infants up to 1 year of age was investigated. METHODS: We evaluated 54 perinatally HIV-infected and 22 HIV-exposed uninfected infants (controls) at the first and second semester of life. All HIV-infected infants had a baseline CD4 of ≥25%, participated in the Comprehensive International Program of Research on AIDS Children with HIV Early Antiretroviral Therapy trial in South Africa, and were randomized in the following groups: group 1 (n = 20), ART deferred until CD4 <25% or severe HIV disease; and group 2 (n = 34), ART initiation within 6 to 12 weeks of age. LPS, endotoxin-core antibodies, soluble CD14 (sCD14), and LPS-binding protein (LBP) were measured in cryopreserved plasma. T-cell activation was measured in fresh whole blood. RESULTS: At the first semester, LPS concentration was higher in HIV-infected infants than in controls; sCD14, LBP, and T-cell activation were higher in group 1 than in group 2 and controls. Although LPS was not correlated with study variables, viral load was positively associated with sCD14, LBP, or endotoxin-core antibodies. At the second semester, LPS was not detectable and elevated host LPS-control molecules values were sustained in all groups and in conjunction with ART in all HIV-infected infants. CONCLUSIONS: Although plasma concentration of LPS was higher in perinatally HIV-infected infants 0 to 6 months of age than in controls independent of ART initiation strategy, concentration of LPS-control molecules was higher in infants with deferred ART, suggesting the presence of increased microbial translocation in HIV-infected infants with sustained early viral replication. Copyright © 2011 by Lippincott Williams & Wilkins.
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Keywords
HIV-1-infected infants, LPS, LPSbinding molecules, microbial translocation
Citation
Pediatric Infectious Disease Journal
30
10
http://www.scopus.com/inward/record.url?eid=2-s2.0-80052933872&partnerID=40&md5=d68aa2434f14499213871712f92bf39d
30
10
http://www.scopus.com/inward/record.url?eid=2-s2.0-80052933872&partnerID=40&md5=d68aa2434f14499213871712f92bf39d