Low CD4+ T-cell levels and B-cell apoptosis in vertically HIV-exposed noninfected children and adolescents

Abstract

Lymphocyte subsets, activation markers and apoptosis were assessed in 20 HIV-exposed noninfected (ENI) children born to HIV-infected women who were or not exposed to antiretroviral (ARV) drugs during pregnancy and early infancy. ENI children and adolescents were aged 6-18 years and they were compared to 25 age-matched healthy non-HIV-exposed children and adolescents (Control). ENI individuals presented lower CD4(+) T cells/mm(3) than Control group (control: 1120.3 vs. ENI: 876.3; t-test, p = 0.030). ENI individuals had higher B-cell apoptosis than Control group (Control: 36.6%, ARV exposed: 82.3%, ARV nonexposed: 68.5%; Kruskal-Wallis, p < 0.05), but no statistical difference was noticed between those exposed and not exposed to ARV. Immune activation in CD4(+) T, CD8(+) T and in B cells was comparable in ENI and in Control children and adolescents. Subtle long-term immune alterations might persist among ENI individuals, but the clinical consequences if any are unknown, and these children require continued monitoring.

Fig 1.

Boxplot of number of CD4⁺ T cells mm⁻³ (A) and caspase-3 expression on B lymphocyte (B) in healthy control group, ENI group who were exposed to antiretroviral drugs (ENI: ARV exposure) during pregnancy and after birth and ENI group who were not exposed to antiretroviral drugs (ENI – no ARV exposure) during pregnancy or after birth. Comparison between groups in respect to CD4⁺ T-cell count was performed with ANOVA, with multiple comparisons performed with Tukey’s test; Caspase-3 expression on B cells was evaluated with Kruskal–Wallis test, with multiple comparisons performed with Dunn’s test.