Abstract
SummaryAntiretroviral therapy (ART) only partially restores HIV‐induced alterations in lymphocyte populations. We assessed B and T cell phenotypes in a cohort of children from a single centre in the United Kingdom with perinatally acquired HIV compared to healthy controls. The majority of HIV infected children (44 of 56) were on fully suppressive combination ART. Children with perinatally acquired HIV had significantly lower memory B and CD4+CD45RO+CXCR5+ [follicular T helper cell (Tfh)‐like] T cell percentages. Detectable viraemia was associated with higher CD21– (activated and exhausted/tissue‐like memory) B cells. A greater proportion of life spent on suppressive ART was associated with higher memory B cell percentages. These results suggest that early and sustained suppressive ART may preserve B and T cell phenotypes in perinatally acquired HIV and limit deficits in humoral immunity. A lower proportion of circulating Tfh‐like cells in HIV infected children appears to be independent of HIV treatment history and ongoing HIV viraemia and warrants further investigation.
Highlights
Perceived as causing an immune defect affecting T cells, there are an expanding number of reports describing B cell phenotype in the context of perinatally acquired HIV
The aims of this study were to determine the influence of paediatric HIV infection on circulating Tfh-like cells and to assess if there was an association between Tfh-like cells and memory B cell subsets
HIV2 median age was lower than HIV1 (107Á5 months versus 151Á5 months, P 5 0Á009); 44 of 56 (78Á6%) of HIV1 patients were on antiretroviral therapy (ART) with an undetectable viral load (VL) at the time of blood sampling
Summary
Perceived as causing an immune defect affecting T cells, there are an expanding number of reports describing B cell phenotype in the context of perinatally acquired HIV. It is clear that HIV infection is associated with phenotypical abnormalities of B cells both on and off antiretroviral therapy (ART). How ART treatment history impacts upon potential for B cell immune preservation/reconstitution in perinatally acquired HIV has evolved more recently as a topic of interest in children [1,2,3,4]. More is known about B cell phenotypical changes in HIV-infected adults. Observed abnormalities can be partially reversed by ART, while earlier initiation of ART can result in the preservation of B cell phenotype and function (reviewed in [5]). There are, important differences in the immunological characteristics of perinatally acquired HIV, and adult infection and caution must be taken when extrapolating from adult data to paediatric populations: perinatally acquired HIV results in an insult to a naive and still-developing immune system, which is reflected in differences in the dynamics of viral replication, immunosuppression, clinical progression and response to ART [6]
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