Early impairment of gut mucosal immunity in HIV-1-infected children

Quesnel, Anne; Moja, Ph.; Blanche, Stéphane; Griscelli, C; Genin, Christian

doi:10.1111/j.1365-2249.1994.tb06098.x

Cited by 13 publications

(2 citation statements)

References 32 publications

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“…First, younger children may have sustained less severe intestinal damage due to a shorter duration of HIV-1 disease allowing them to more effectively absorb nutrients after viral suppression [24,25]. HIV-1-related compromises in gastrointestinal permeability may result in malabsorption and may be less quickly restored after longer duration of HIV-1 [26,27]. In addition, longer HIV-1 duration results in chronic systemic immune activation, which may require more time to reverse and thus, exert a more prolonged metabolic cost [28,29].…”

Section: Discussionmentioning

confidence: 99%

Younger age at HAART initiation is associated with more rapid growth reconstitution

McGrath

Chung

Richardson

et al. 2011

Aids

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Objectives Patterns of growth following highly active antiretroviral therapy (HAART) administration among children are not well defined. The objective of this study was to determine rates and predictors of growth reconstitution among children on HAART. Methods A study was conducted among HIV-1-infected children initiating HAART at an HIV treatment clinic in Kenya. Kaplan–Meier survival curves and Cox proportional hazards regression models compared catch-up growth (Z-score ≥0) at 12 months post-HAART. Multivariate linear mixed-effects models determined rates and predictors of growth following HAART. Results One hundred and seventy-three HIV-1-infected children initiated HAART with a median age of 4.7 years [interquartile range (IQR) 2.4, 7.0]. At baseline, children below 3 years had lower weight-for-age (WAZ) and weight-for-height (WHZ) Z-scores than children 3–5 and 6–10 years (WAZ: P = 0.03; WHZ: P = 0.006). Adjusting for baseline growth, children below 3 years were two to three-fold more likely to attain population age-norms (Z-score = 0) than 6–10 years (WAZ: P = 0.055; WHZ: P = 0.005) at 12 months post-HAART. After adjustment, children below 3 years had higher increases in WAZ and WHZ following HAART than 6–10 years (WAZ: P = 0.006; WHZ: P = 0.005). Children at WHO stage at least 3 at baseline experienced more rapid WHZ reconstitution (P = 0.002). Food supplementation while on HAART was associated with increased monthly gains in weight indices (WAZ: P = 0.001; WHZ: P = 0.005), and multivitamins were associated with greater increases in height (P < 0.01). Conclusion Following HAART initiation, younger children had more rapid catch-up to the population-average weight of their peers than older children, demonstrating growth benefit of earlier HAART. In addition to HAART, food supplementation and multivitamins may also accelerate growth reconstitution.

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Section: Discussionmentioning

confidence: 99%

Younger age at HAART initiation is associated with more rapid growth reconstitution

McGrath

Chung

Richardson

et al. 2011

Aids

View full text Add to dashboard Cite

show abstract

“…They also have higher total and specific fecal IgA levels than AIDS patients with other enteric infections or normal controls (5, 15). As the number of CD4 ϩ T cells decreases in HIV-infected individuals, mucosal antibody responses may become aberrant, and there may be increases in the levels of polyreactive T-cell-independent antibodies and serum-derived IgA and IgG (42,75). Polyreactive antibodies may not be sufficient to clear infection.…”

Section: B Cells and Antibodiesmentioning

confidence: 99%