期刊
PEDIATRIC INFECTIOUS DISEASE JOURNAL
卷 30, 期 10, 页码 877-882出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/INF.0b013e31821d141e
关键词
HIV-1-infected infants; LPS; microbial translocation; LPS-binding molecules
资金
- National Institute of Allergy and Infectious Disease NIH [AI062512]
- The Philadelphia Foundation
- The Stengel-Miller family
- Commonwealth of Pennsylvania
- Commonwealth Universal Research Enhancement Program
- Pennsylvania Department of Health
- Cancer Center [P30 CA10815]
- National Institute of Allergy and Infectious Diseases (NIAID) of the US National Institutes for Health (NIH) [U19 AI53217]
- Department of Health of the Western Cape, South Africa
- Department of Health of the Gauteng, South Africa
- GlaxoSmithKline plc
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.
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