Early progression of disease in HIV-infected infants with thymus dysfunction
Early progression of disease in HIV-infected infants with thymus dysfunction
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DOI：
10.1056/nejm199611073351904
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发表时间：
1996-11-07
影响因子：
158.5
通讯作者：
Nesheim, S
中科院分区：
文献类型：
--
作者：
Kourtis, AP;Ibegbu, C;Nesheim, S
背景先天性胸腺缺陷婴儿（DiGeorge综合征）具有免疫缺陷和低CD4+和CD8+ t淋巴细胞计数和低CD5+ b淋巴细胞计数的特征性模式。由于胸腺对CD4+细胞的生成至关重要，我们寻找围产期感染人类免疫缺陷病毒（HIV）的婴儿胸腺功能障碍的证据。方法对59例经母体感染HIV的婴儿、5例DiGeorge综合征婴儿和168例暴露于HIV但未感染的婴儿进行免疫表型研究。假定胸腺缺陷的标准是在出生后的前六个月CD4+和CD8+ T细胞亚群的减少，在婴儿亚群中通过CD4+CD45RA+和CD4+CD45RO+ T细胞和CD5+ B细胞的低计数得到证实。结果在59例hiv感染婴儿中，17例的免疫表型与DiGeorge综合征婴儿相似。这17名婴儿在12个月和24个月时患获得性免疫缺陷综合征（艾滋病）的风险分别为75%和92%，而其他42名婴儿的风险分别为14%和34%
Background Infants with congenital thymic deficiency (the DiGeorge syndrome) have immunodeficiency and a characteristic pattern of low CD4+ and CD8+ T-lymphocyte counts and low CD5+ B-lymphocyte counts. Because the thymus is essential for the generation of CD4+ cells, we sought evidence of thymus dysfunction in infants infected perinatally with the human immunodeficiency virus (HIV).Methods We studied the immunophenotypes of 59 infants with maternally transmitted HIV, 5 infants with the DiGeorge syndrome, and 168 infants exposed to HIV but not infected. The criteria for a presumed thymic defect were reductions in both the CD4+ and CD8+ T-cell subgroups during the first six months of life that were confirmed in a subgroup of infants by low counts of CD4+CD45RA+ and CD4+CD45RO+ T cells and CD5+ B cells.Results Of the 59 HIV-infected infants, 17 had immunophenotypes similar to those of infants with the DiGeorge syndrome. The risks of the acquired immunodeficiency syndrome (AIDS) by the ages of 12 and 24 months were, respectively, 75 percent and 92 percent in these 17 infants, as compared with 14 and 34 percent in the other 42 infants (P