Allergic diseases in subjects under 18 years living with HIV

Abstract

BackgroundIn recent decades there has been an increase in the prevalence of allergic disease. Manifestations of these diseases have allegedly been observed in people living with Human Immunodeficiency Virus (HIV), however, few studies have been directed at patients under 18 years old. In this context, the aim of this study is to estimate the prevalence of allergic disease in patients under 18 years old, living with HIV, and to investigate the relationship between clinico-immunological characteristics of the HIV infection and atopy.MethodsThis is a cross-sectional epidemiological study involving patients under 18 years of age who were followed up by specialized HIV services in the Southern Region of the State of Santa Catarina, Brazil, from February to October 2012. Data collection tools included a questionnaire established by the International Study of Asthma and Allergy in Childhood (ISAAC), socio-demographic data, as well as laboratory test results obtained from the medical records. Blood samples were taken to measure total serum Immunoglobulin E (IgE) levels and a Radioallergosorbent Test (RAST) for the main aeroallergens. Analysis was performed using Student’s t test, chi-squared, Fisher’s exact and Mann–Whitney tests, wherever indicated, with p < 0.05 value considered significant.Results29 individuals were evaluated. The prevalence of symptoms of allergic disease was 65.5% (95% CI 56.1-74.8), the most frequent being rhinitis 44.8% (95% CI 35.0-54.5), followed by asthma 37.9% (95% CI 28.3-47.4) and eczema 27.6% (95% CI 18.8-36.3). RAST was positive in 20.7% of the individuals. There was no significant difference in terms of total serum IgE between individuals with and without symptoms of allergic disease. Nevertheless, a high frequency of raised levels of total serum IgE (40.7%) and an association between raised IgE and clinical staging of disease were observed. A further association between CD8+ cell count and prevalence of symptomatic allergic disease (p = 0.014) was observed.ConclusionThere was a high prevalence of reported allergic disease, as well as a high frequency of raised levels of total serum IgE. The association between CD8+ cell count and the prevalence of symptomatic allergic disease corroborates studies that demonstrated the role of such cells in the development of allergic disease.

Serum Immunoglobulin E levels and Atopic Diseases in Human Immunodeficiency Virus-Infected and Non-Infected Children and Their Association with the Severity of HIV Infection at a Tertiary Hospital, South-West Nigeria

“…Eosinophils release intracellular granules which are sources of inflammatory proteins which cause damage to epithelial cells, induce airway hyperreactivity and hyperresponsiveness. [27] Linhar et al [9] and Masekela et al [21] reported higher prevalence of atopic diseases among HIV-infected children in Sao Paulo, Brazil and Pretoria, South Africa respectively when compared to what was obtained in this study. This could partly be due to environmental factor of the study location (Osogbo, Nigeria), which is basically an agrarian community devoid of industrial pollution which may contribute to atopic manifestations.…”

“…[8] They have been reported to be associated with HIV infection and, in fact, they have been found to exhibit their clinical symptoms and signs in individuals living with HIV. [9] Increase in serum IgE levels in HIVinfected individuals had been reported in some studies. [10,11] This increased level has been attributed to be impaired T-cell suppressive control on the B-cell antibody synthesis (immune dysregulation) leading to hypergammaglobulinaemia.…”

“…This was not a surprise because clinical manifestations of atopic diseases have been documented in individuals with HIV infection. [9,13] A possible disequilibrium in the Th1-Th2 cytokines with Th2 taking pre-eminence suggests a predilection for atopic diseases in these patients. [26] Th2 cytokines play important roles in the pathogenesis of Funso Abidemi Olagunju et.al.…”

“…[12] Similarly increased prevalence of atopic diseases in HIV-infected patients had also been documented. [9,13] However, in Nigeria, there still exists a paucity of data on the serum IgE levels and the prevalence of atopic diseases in HIVinfected children compared to their noninfected counterparts. Also and to the best of the authors' knowledge, only one study in Nigeria assessed the association between the levels of serum immunoglobulin classes except for IgE levels and the severity of HIV infection in children in terms of Cluster of differentiation (CD) 4+ T-lymphocyte count.…”

Case Report: Safe and Effective Sublingual Birch Allergen Immunotherapy in Two HIV-Positive Patients

“…The emergence of effective ART has enabled HIV-positive patients to enjoy much the same quality of life and life expectancy as the general population (12). However, allergies are not rare in people living with HIV (13)(14)(15). The lack of data on the efficacy and safety of AIT in HIV-positive people patients means that these patients are typically refused access to an effective, disease-modifying therapy.…”