Characteristics of lymphocyte subsets in HIV-infected, long-term nonprogressor, and healthy Asian children through 12 years of age

Abstract

Background There are limited data on the immune profiles of HIV-positive children, compared with healthy controls, and no such data for Asian children. Objectives To immunophenotype HIV-positive Asian children, including long-term non-progressors (LTNPs), compared with age-matched healthy controls. Methods We used flow cytometry to analyze 13 lymphocyte and monocyte subsets from 222 untreated, HIV-positive children with 15%–24% CD4+ T cells and no AIDS-related illnesses and 142 healthy children (controls). Data were compared among age categories. Profiles from LTNPs (n=50), defined as children≥ 8 years old with CD4+ T-cell counts ≥ 350 cells/mm3, were compared with data from age-matched non-LTNPs (n=17) and controls (n=53). Results Compared with controls, HIV-positive children had lower values (cell count per mm3 and percent distribution) for helper T cells and higher values for cytotoxic T cells, with reductions in populations of naïve helper and cytotoxic T cells, B cells, and natural killer (NK) cells. HIV-positive children had high values for activated helper and cytotoxic T cells. Compared with non-LTNPs, LTNPs had higher values of helper and cytotoxic T cells, naïve and memory T-cell subsets, and B and NK cells. Surprisingly, counts of activated helper and cytotoxic T cells were also higher among LTNPs. LNTPs were more frequently male. Conclusions Untreated, HIV-infected Asian children have immune profiles that differ from those of controls, characterized by low values for helper T cells, naive T cells, B cells, and NK cells but high values for cytotoxic, activated helper, and cytotoxic T cells. The higher values for activated T cells observed in LTNPs require confirmation in longitudinal studies. Clinical Implications The distinct immunologic profile of LTNPs might identify lymphocyte subsets associated with HIV disease progression.

Control lymphocyte subsets: Can one country's values serve for another's?

“…We and others have reported that lymphocyte patterns are affected by ethnicity, gender and environmental factors 1-3 . Differing exposure to infectious agents such as malaria, tuberculosis and cytomegalovirus could underlie differences in lymphocyte subsets patterns in contrasting settings 4-6 .…”

“…Differing exposure to infectious agents such as malaria, tuberculosis and cytomegalovirus could underlie differences in lymphocyte subsets patterns in contrasting settings 4-6 . In this study, we analyzed combined data from three studies of healthy children from Thailand 1 , Malawi 2 and the USA 3 that had used similar standard flow cytometric methods and markers, thus allowing assessment of immune heterogeneity across settings with differences in ethnicity and infectious disease exposure.…”

“…We used lymphocyte subset data from healthy children aged 0 to15 years enrolled in our previously published studies 1-3 ; additional Thai subjects < 2 years were recruited to allow comparisons with the youngest children. Exclusion criteria were febrile illness, clinical infection at screening, concomitant medical illnesses potentially resulting in abnormal immunity, or abnormal growth (defined as <3 rd or >97 th percentiles of the country's growth chart for Thai and US children, or weight-for-height Z-score <70% for Malawian children).…”

HLA-DRB1454 and predictors of new-onset asthma in HIV-infected Thai children

“…Flow cytometry was performed at baseline by methods previously described for the following cell subsets: activated CD4 (CD4 + 38 + DR + ) and activated CD8 (CD8 + 38 + DR + ) T cells [6]. C Reactive Protein (CRP) was measured using the CRP High Sensitive Assay (Cobas Integra System, Roche Diagnostic Systems, Basel, Switzerland).…”

“…inhaled budesonide, unspecified oral/inhaled bronchodilator, and salbutamol + budesonide) (12.5%). Median (IQR) durations of medications use were 16 (10-41) days for salbutamol, 7 [5][6][7][8] days for terbutaline, 167 (34-427) days for budesonide, and 5 [2][3][4][5][6] days for bronchodilator with no differences between arms (all p N 0.2).…”