Abstract
IntroductionThe number of HIV exposed uninfected (HEU) infants is increasing as vertical transmission is reducing. This subpopulation requires more investigations. This study aimed at comparing the expression level of soluble Fas receptors (FasR) and ligands (FasL) between HIV infected, HEU and unexposed children.MethodsEighty eight HIV-1infected, 86 HEU and 38 HIV unexposed children were recruited. Soluble FasR and FasL were measured in their plasma. Mann-Whitney U-Test was used to compare groups with 95% confidence. Spearman coefficient was used to test the correlation with CD4 and viral load (VL).ResultsOverall plasma levels of FasR were higher than that of FasL. The concentration of FasR and FasL were significantly higher in HIV-1 infected children in comparison to HEU and unexposed children. There was no difference in the plasma level of FasL in HIV infected compared to HEU children. A significant difference was observed between HIV infected children and HEU children (P=0.001) for the FasL. FasR were higher in both HIV infected and unexposed children compared to HEU children. There was a positive correlation (rs=+0.4; p=0.01) in ARV treated children between CD4 count and FasL concentration. Significant negative correlation (rs=-0.3; p=0.040) in ARV naïve children was observed between CD4 percentage and FasL. Significant and positive correlation (rs=+0.4; p=0.008) was observed between the VL and FasL in HIV infected, treated or not.ConclusionHEU children differ from HIV infected and unexposed children as the level of FasL/R expression is concerned. HEU should be considered different from HIV unexposed although exempt from virus as some immune dysfunctions have been reported among them.
Highlights
The acquired immunodeficiency syndrome (AIDS) epidemic has harshly affected child mortality all over the world but intervention to prevent mother to child transmission has successfully reduced the risk of HIV transmission to < 1% in resource rich settings [1]
Plasma concentrations of Fas ligands (FasL) were higher in Human immunodeficiency virus type 1 (HIV-1) infected children compared to HIV exposed uninfected (HEU) and unexposed children with a p value of 0.009 (Figure 1 A)
Plasma levels of Fas receptors (FasR) were higher in HIV-1 infected children compared to HEU and unexposed children with p
Summary
The AIDS epidemic has harshly affected child mortality all over the world but intervention to prevent mother to child transmission has successfully reduced the risk of HIV transmission to < 1% in resource rich settings [1]. Despite the greatest success of ART in HIV infection history, prevention of mother to child transmission remains an important challenge especially in sub-Saharan African countries where HIV-exposed uninfected (HEU) infants are more susceptible to morbidity and mortality due to many infectious mechanisms than their unexposed peers [5]. HEU infants represent a growing population in pediatric, they can represent nearly 30% of the newborn population in some endemic nations [6] Even if these infants are not infected, they are affected by the virus and by the treatment receive by their mother during pregnancy to prevent transmission [7]. Infection caused by the Human immunodeficiency virus type 1 (HIV-1) is characterized by a progressive and severe depletion of CD4+ T lymphocytes [8] This phenomenon is observed in both adult and children. This study aimed firstly, to evaluate the level of soluble Fas receptors and ligands in HIV-infected children vertically infected, receiving antiretroviral treatment (ART) or not, and HEU children and unexposed children (controls); secondly, to assess the correlation between plasma concentrations of Fas receptors/ligands, CD4 lymphocyte cells counts and HIV-1 viral load in HIV infected children
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