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 log10-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.
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 log10-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.
Authors: Eleonora A M L Mutsaerts; Marta C Nunes; Martijn N van Rijswijk; Kerstin Klipstein-Grobusch; Kennedy Otwombe; Mark F Cotton; Avy Violari; Shabir A Madhi Journal: Clin Infect Dis Date: 2019-08-01 Impact factor: 9.079
Authors: Omphile E Simani; Alane Izu; Marta C Nunes; Avy Violari; Mark F Cotton; Nadia Van Niekerk; Peter V Adrian; Shabir A Madhi Journal: Expert Rev Vaccines Date: 2018-11-19 Impact factor: 5.217
Authors: Monika Esser; Tobias R Kollmann; Brian A Reikie; Rozanne C M Adams; Aleksandra Leligdowicz; Kevin Ho; Shalena Naidoo; Candice E Rusk; Corena de Beer; Wolfgang Preiser; Mark F Cotton; David P Speert Journal: J Acquir Immune Defic Syndr Date: 2014-07-01 Impact factor: 3.731