T lymphocytes among HIV-infected and -uninfected infants: CD4/CD8 ratio as a potential tool in diagnosis of infection in infants under the age of 2 years

Zijenah, Lynn S.; Katzenstein, David; Nathoo, Kusum; Rusakaniko, Simbarashe; Tobaiwa, Ocean; Gwanzura, Christine; Bikoué, Arsène; Nhembe, Margaret; Matibe, Petronella; Jánossy, G.

doi:10.1186/1479-5876-3-6

Cited by 29 publications

(7 citation statements)

References 17 publications

(15 reference statements)

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“…Clinical studies have demonstrated the use of the CD4/CD8 ratio as an indicator of immunocompromise in HIV-infected individuals, with high sensitivity (98%) and specificity (Ͼ98%), particularly for children Ͻ2 years of age (55,56). However, a recent study by Leung et al concluded that CD4/CD8 ratio normalization might not have additional short-term predictive value for clinical outcomes after accounting for other risk factors, such as age and HIV load (57).…”

Section: Discussionmentioning

confidence: 90%

HIV Infection and Microbial Diversity in Saliva

et al. 2014

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f Limited information is available about the effects of HIV and subsequent antiretroviral treatment on host-microbe interactions. This study aimed to determine the salivary microbial composition for 10 HIV-seropositive subjects, before and 6 months after highly active antiretroviral therapy (HAART), compared with that for 10 HIV-seronegative subjects. A conventional culture and two culture-independent analyses were used and consistently demonstrated differences in microbial composition among the three sets of samples. HIV-positive subjects had higher levels of total cultivable microbes, including oral streptococci, lactobacilli, Streptococcus mutans, and Candida, in saliva than did HIV-negative subjects. The total cultivable microbial levels were significantly correlated with CD4 ؉ T cell counts. Denaturing gradient gel electrophoresis (DGGE), which compared the overall microbial profiles, showed distinct fingerprinting profiles for each group. The human oral microbe identification microarray (HOMIM) assay, which compared the 16S rRNA genes, showed clear separation among the three sample groups. Veillonella, Synergistetes, and Streptococcus were present in all 30 saliva samples. Only minor changes or no changes in the prevalence of Neisseria, Haemophilus, Gemella, Leptotrichia, Solobacterium, Parvimonas, and Rothia were observed. Seven genera, Capnocytophaga, Slackia, Porphyromonas, Kingella, Peptostreptococcaceae, Lactobacillus, and Atopobium, were detected only in HIVnegative samples. The prevalences of Fusobacterium, Campylobacter, Prevotella, Capnocytophaga, Selenomonas, Actinomyces, Granulicatella, and Atopobium were increased after HAART. In contrast, the prevalence of Aggregatibacter was significantly decreased after HAART. The findings of this study suggest that HIV infection and HAART can have significant effects on salivary microbial colonization and composition.

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Section: Discussionmentioning

confidence: 90%

HIV Infection and Microbial Diversity in Saliva

et al. 2014

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“…Perturbations of T cell subsets in severe malarial anemia and uncomplicated malaria resulted in increased proportions of children with reversed CD4/CD8 ratios (ratio of <1.0). Such a result has been proposed as a surrogate for HIV infection in African children ( 26 ). Therefore, the CD4/CD8 ratio should not be used in this way in the presence of active clinical infections, particularly malaria.…”

Section: Discussionmentioning

confidence: 99%

Lymphocyte Perturbations in Malawian Children with Severe and Uncomplicated Malaria

Mandala

Msefula

Gondwe

et al. 2016

Clin Vaccine Immunol

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Lymphocytes are implicated in immunity and pathogenesis of severe malaria. Since lymphocyte subsets vary with age, assessment of their contribution to different etiologies can be difficult. We immunophenotyped peripheral blood from Malawian children presenting with cerebral malaria, severe malarial anemia, and uncomplicated malaria (n = 113) and healthy aparasitemic children (n = 42) in Blantyre, Malawi, and investigated lymphocyte subset counts, activation, and memory status. Children with cerebral malaria were older than those with severe malarial anemia. We found panlymphopenia in children presenting with cerebral malaria (median lymphocyte count, 2,100/μl) and uncomplicated malaria (3,700/μl), which was corrected in convalescence and was absent in severe malarial anemia (5,950/μl). Median percentages of activated CD69+ NK (73%) and γδ T (60%) cells were higher in cerebral malaria than in other malaria types. Median ratios of memory to naive CD4+ lymphocytes were higher in cerebral malaria than in uncomplicated malaria and low in severe malarial anemia. The polarized lymphocyte subset profiles of different forms of severe malaria are independent of age. In conclusion, among Malawian children cerebral malaria is characterized by lymphocyte activation and increased memory cells, consistent with immune priming. In contrast, there are reduced memory cells and less activation in severe malaria anemia. Further studies are required to understand whether these immunological profiles indicate predisposition of some children to one or another form of severe malaria.

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“…A CD4:CD8 T-lymphocyte ratio less than 1.0 is associated with HIV infection and has been proposed as a parameter for the diagnosis of HIV in African children under 18 months old, 32 where results of HIV rapid tests can be complicated by maternal antibody to HIV. 10,32 With decreased CD4 + and increased CD8 + T-lymphocyte concentrations in young children in this study compared with results from developed countries, 13% of Malawian children under 18 months had a CD4:CD8 ratio <1.0. Therefore, a CD4:CD8 ratio <1.0 is not specific for HIV infection, and this parameter should be used with caution in HIV diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Lymphocyte subsets in healthy Malawians: Implications for immunologic assessment of HIV infection in Africa

Mandala

MacLennan

Gondwe

et al. 2010

Journal of Allergy and Clinical Immunology

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BackgroundCD4+T lymphocyte measurements are the most important indicator of mortality in HIV-infected individuals in resource-limited settings. There is currently a lack of comprehensive immunophenotyping data from African populations to guide the immunologic assessment of HIV infection.ObjectiveTo quantify variation in absolute and relative lymphocyte subsets with age in healthy Malawians.MethodsLymphocyte subsets in peripheral blood of 539 healthy HIV-uninfected Malawians stratified by age were enumerated by flow cytometry.ResultsB and T–lymphocyte and T-lymphocyte subset absolute concentrations peaked in early childhood then decreased to adult levels, whereas lymphocyte subset proportions demonstrated much less variation with age. Adult lymphocyte subsets were similar to those in developed countries. In contrast, high B-lymphocyte and CD8+T-lymphocyte levels among children under 2 years, relative to those in developed countries, resulted in low CD4+T-lymphocyte percentages that varied little between 0 and 5 years (35% to 39%). The CD4+T-lymphocyte percentages in 35% of healthy children under 1 year and 18% of children age 1 to 3 years were below the World Health Organization threshold defining immunodeficiency in HIV-infected children in resource-limited settings. Thirteen percent of healthy children under 18 months old had a CD4:CD8T-lymphocyte ratio <1.0, which is commonly associated with HIV infection. All immunologic parameters except absolute natural killer lymphocyte concentration varied significantly with age, and percentage and overall absolute CD4+T-lymphocyte counts were higher in females than males.ConclusionAlthough lymphocyte subsets in Malawian adults are similar to those from developed countries, CD4+T-lymphocyte percentages in young children are comparatively low. These findings need to be considered when assessing the severity of HIV-related immunodeficiency in African children under 3 years.

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T lymphocytes among HIV-infected and -uninfected infants: CD4/CD8 ratio as a potential tool in diagnosis of infection in infants under the age of 2 years

Cited by 29 publications

References 17 publications

HIV Infection and Microbial Diversity in Saliva

HIV Infection and Microbial Diversity in Saliva

Lymphocyte Perturbations in Malawian Children with Severe and Uncomplicated Malaria

Lymphocyte subsets in healthy Malawians: Implications for immunologic assessment of HIV infection in Africa

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