Dysfunction of natural killer cells in human immunodeficiency virus-infected children with or without Pneumocystis carinii pneumonia.
The development of Pneumocystis carinii pneumonia (PCP) in human immunodeficiency virus (HIV)-infected children with normal T-cell numbers is contrary to previous experience with HIV-infected adults, in whom low CD4+ T-cell numbers predict susceptibility to PCP. To determine whether PCP in HIV-infected children reflects a qualitative T-cell or other immune defect, we studied four HIV-infected children who also had PCP and 10 others without PCP for T-cell and natural killer (NK) cell function. Most of the HIV-infected children had normal T-cell numbers for age, and all had CD4+ T-cell numbers greater than those predictive of PCP in HIV-infected adults. All HIV-infected children had normal T-cell function in vitro. The HIV-infected children as a whole had deficient NK cell cytolysis. We obtained a significant interactive effect of age by health status for NK cell function between patients and age-matched control subjects. All HIV-infected children with defective NK cell function failed to enhance their NK cell cytolysis when their mononuclear cells were stimulated with recombinant interferon alfa (r-IFN-alpha). This NK cell defect in HIV-infected children may facilitate the development of secondary infection.
Department of Pediatrics, Schneider Children's Hospital, Long Island Jewish Medical Center, New Hyde Park, New York 11042.
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VR
Bonagura
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Cunningham-Rundles
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S
Schuval
D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000150:complications / Q000276:immunology*; D000906:Antibodies / Q000032:analysis; D015496:CD4-Positive T-Lymphocytes; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D007223:Infant; D007694:Killer Cells, Natural / Q000276:immunology*; D007958:Leukocyte Count; D008297:Male; D009894:Opportunistic Infections / Q000097:blood / Q000150:complications / Q000276:immunology*; D011020:Pneumonia, Pneumocystis / Q000097:blood / Q000150:complications / Q000276:immunology*; D013601:T-Lymphocytes; D013745:Tetanus Toxoid / Q000276:immunology
D000906:Antibodies; D007136:Immunoglobulins; D013745:Tetanus Toxoid