Cytomegalovirus Infection May Contribute to the Reduced Immune Function, Growth, Development, and Health of HIV-Exposed, Uninfected African Children.
Cytomegalovirus Infection May Contribute to the Reduced Immune Function, Growth, Development, and Health of HIV-Exposed, Uninfected African Children.
复制标题
DOI：
10.3389/fimmu.2016.00257
复制
发表时间：
2016
影响因子：
7.3
通讯作者：
Rowland-Jones S
中科院分区：
文献类型：
--
作者：
Filteau S;Rowland-Jones S
随着非洲抗逆转录病毒疗法的普及，感染艾滋病毒的母亲所生的大多数儿童本身并没有感染艾滋病毒。与未感染艾滋病毒的儿童相比，这些感染艾滋病毒但未感染艾滋病毒的儿童死亡风险增加，免疫、生长、发育和健康方面存在缺陷。众所周知，高浓缩铀儿童在生命早期感染巨细胞病毒的风险高于未感染艾滋病毒的儿童。这种风险在很大程度上不受抗逆转录病毒疗法的影响，而母乳喂养会增加这种风险，母乳喂养本身对儿童健康和生存至关重要。早期CMV感染，即在子宫内或婴儿早期，可能导致生长减缓，免疫功能改变或受损，以及感觉和认知缺陷。我们审查的证据表明，巨细胞病毒可能是负责高浓缩铀儿童的健康损害。目前还没有理想的安全有效的干预措施来减少出生后CMV感染。如果一项临床试验证明减少早期巨细胞病毒感染可改善高浓缩铀儿童的健康和发育，这将为制定更好的干预措施以改善这一弱势群体的健康提供所需的动力。
With increasing access to antiretroviral therapy (ART) in Africa, most children born to HIV-infected mothers are not themselves HIV-infected. These HIV-exposed, uninfected (HEU) children are at increased risk of mortality and have immune, growth, development, and health deficits compared to HIV-unexposed children. HEU children are known to be at higher risk than HIV-unexposed children of acquiring cytomegalovirus (CMV) infection in early life. This risk is largely unaffected by ART and is increased by breastfeeding, which itself is critically important for child health and survival. Early CMV infection, namely in utero or during early infancy, may contribute to reduced growth, altered or impaired immune functions, and sensory and cognitive deficits. We review the evidence that CMV may be responsible for the health impairments of HEU children. There are currently no ideal safe and effective interventions to reduce postnatal CMV infection. If a clinical trial showed proof of the principle that decreasing early CMV infection improved health and development of HEU children, this could provide the impetus needed for the development of better interventions to improve the health of this vulnerable population.