Maternal and infant factors and lymphocyte, CD4 and CD8 cell counts in uninfected children of HIV-1-infected mothers
Maternal and infant factors and lymphocyte, CD4 and CD8 cell counts in uninfected children of HIV-1-infected mothers
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DOI：
10.1097/01.aids.0000174454.63250.22
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发表时间：
2005-07-01
期刊：
影响因子：
3.8
通讯作者：
Iorio, R
中科院分区：
文献类型：
--
作者：
Bunders, M;Thorne, C;Iorio, R
目的：评价抗逆转录病毒治疗（ART）对母婴传播HIV的影响，以及HIV-1感染母亲的未感染儿童的婴儿/母亲特征对总淋巴细胞（TLC）和淋巴细胞亚群的影响。设计：欧洲合作研究采用标准方案对1663名未感染儿童从出生到至少8岁进行随访。平滑曲线（运行中位数）说明了ART暴露和种族随年龄变化的免疫标志物模式。在线性回归分析中，使用LMS方法对对数（10）转换的TLC、CD 4和CD 8细胞计数进行建模后获得的z评分，量化淋巴细胞参数与母体/婴儿特征之间的关联。考克斯比例风险模型评估了至TLC、CD 4和CD 8细胞计数低于规定临界值的时间。协变量包括早产，性别，种族，停药和ART exposition.Results：总体而言，黑人儿童有较低的TLC，CD 4和CD 8细胞计数比白色儿童，TLC，CD 4和CD 8细胞计数低于截止值的风险增加。ART暴露与TLC水平相关（但与低于淋巴细胞减少临界值的TLC无关），在生命的第一年中CD 4细胞计数减少，并且在至少8岁之前CD 8细胞计数减少。ART暴露的持续时间和强度与TLC levels.Conclusion：ART暴露在胎儿和生命早期的TLC和CD 8细胞计数的影响延长到至少8年。这些结果增加了与用于预防母婴传播艾滋病毒的抗逆转录病毒疗法相关的日益增多的不良反应清单。(c)2005年利平科特威廉姆斯&威尔金斯。
Objective: To evaluate the effects of antiretroviral treatment (ART) for mother-to-child transmission of HIV and infant/maternal characteristics on total lymphocytes (TLC) and lymphocyte subsets in uninfected children of HIV-1-infected mothers.Design: The European Collaborative Study followed 1663 uninfected children from birth until at least 8 years of age using a standard protocol.Methods: Smoothers (running medians) illustrated patterns of immune markers over age by ART exposure and race. Associations between lymphocyte parameters and maternal/infant characteristics were quantified in linear regression analyses using z-scores obtained after modelling log(10)-transformed TLC, CD4 and CD8 cell counts using the LMS method. Cox proportional hazard models assessed time to TLC, CD4 and CD8 cell counts below the defined cut-off. Covariates included prematurity, gender, race, drug withdrawal and ART exposure.Results: Overall, black children had lower TLC, CD4 and CD8 cell counts than white children, and an increased risk of TLC, CD4 and CD8 cell counts below the cut-off. ART exposure was associated with TLC levels (but not with TLC below the cut-off for lymphopenia), with reduced CD4 cell counts in the first year of life, and with reduced CD8 cell counts until at least 8 years of age. Duration and intensity of ART exposure was associated with TLC levels.Conclusion: The effect of ART exposure in fetal and early life on TLC and CD8 cell counts was prolonged until at least 8 years. These results add to the growing list of adverse effects associated with ART used as prevention of mother-to-child transmission of HIV. (c) 2005 Lippincott Williams & Wilkins.