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. 2013 Dec 26;8(12):e82783.
doi: 10.1371/journal.pone.0082783. eCollection 2013.

Humoral immune responses to Pneumocystis jirovecii antigens in HIV-infected and uninfected young children with pneumocystis pneumonia

Kpandja Djawe  1 , Kieran R Daly  2 , Linda Levin  1 , Heather J Zar  3 , Peter D Walzer  4
Affiliations

Humoral immune responses to Pneumocystis jirovecii antigens in HIV-infected and uninfected young children with pneumocystis pneumonia

Kpandja Djawe et al. PLoS One. .

Abstract

Background: Humoral immune responses in human immunodeficiency virus (HIV)-infected and uninfected children with Pneumocystis pneumonia (PcP) are poorly understood.

Methods: Consecutive children hospitalized with acute pneumonia, tachypnea, and hypoxia in South Africa were investigated for PcP, which was diagnosed by real-time polymerase chain reaction on lower respiratory tract specimens. Serum antibody responses to recombinant fragments of the carboxyl terminus of Pneumocystis jirovecii major surface glycoprotein (MsgC) were analyzed.

Results: 149 children were enrolled of whom 96 (64%) were HIV-infected. PcP occurred in 69 (72%) of HIV-infected and 14 (26%) of HIV-uninfected children. HIV-infected children with PcP had significantly decreased IgG antibodies to MsgC compared to HIV-infected patients without PcP, but had similar IgM antibodies. In contrast, HIV-uninfected children with PcP showed no change in IgG antibodies to MsgC, but had significantly increased IgM antibodies compared to HIV-uninfected children without PCP. Age was an independent predictor of high IgG antibodies, whereas PcP was a predictor of low IgG antibodies and high IgM antibodies. IgG and IgM antibody levels to the most closely related MsgC fragments were predictors of survival from PcP.

Conclusions: Young HIV-infected children with PcP have significantly impaired humoral immune responses to MsgC, whereas HIV-uninfected children with PcP can develop active humoral immune responses. The children also exhibit a complex relationship between specific host factors and antibody levels to MsgC fragments that may be related to survival from PcP.

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Conflict of interest statement

Competing Interests: ASTRA-Zeneca gave a research grant to the South African Thoracic Society (SATS) and the grant was administered by SATS. ASTRA-Zeneca had nothing how SATS administered the grant or spent the money. ASTRA-Zeneca had nothing to do with any other relevant declarations relating to employment, consultancy, patents, products in development, or marketed products etc). We also confirm that this grant does not alter our adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in our guide for authors.

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