Immunologic characterization of children vertically infected with human immunodeficiency virus, with slow or rapid disease progression.
Cytokine production of unstimulated and mitogen-stimulated peripheral blood mononuclear cells of 31 children vertically infected with human immunodeficiency virus type 1 (HIV) and with different patterns of disease progression was evaluated to establish possible correlations between the immunologic and the clinical findings. Production of interferon gamma and interleukin-2 (type 1 cytokines), and of interleukin-4 and interleukin-10 (type 2 cytokines), was analyzed in seven symptom-free patients (Centers for Disease Control and Prevention class P-1B), 10 patients with mild symptoms (class P-2A), and 14 patients with severe symptoms (class P-2B-F). Cytokine production was compared with that of 10 age- and sex-matched control subjects who were seronegative for HIV. The HIV-infected patients produced significantly fewer type 1 cytokines and significantly more type 2 cytokines than the uninfected control subjects. No differences in the production of interferon gamma and interleukin-2 were detected among the different clinical categories of HIV-infected patients. In contrast, interleukin-4 production was augmented in the patients with class P-2A (p < 0.05) and class P-2B-F HIV infection (p < 0.03), in comparison with the children with class P-1B infection. The increase in interleukin-4 production was paralleled by an increase in the number of children with hyperimmunoglobulinemia E in each of the clinical groups (0% in class P-1B; 40% in class P-2A; and 71% in class P-2 B-F infection). Similarly, interleukin-10 production was increased both in patients with class P-2A and in those with class P-2B-F infection, in comparison with the children with class P-1B disease (p < 0.006 and < 0.04, respectively). These data indicate (1) that vertically acquired HIV infection results in decreased production of type 1 cytokines and in increased production of type 2 cytokines, and (2) that an increased production of type 2 cytokines correlates with hyperimmunoglobulinemia E and is present in, and may be characteristic of, the symptomatic phases of childhood HIV infection.
Viganó
A
A
Cattedra di Pediatria IV, H. L. Sacco, Milan, Italy.
Principi
N
N
Villa
M L
ML
Riva
C
C
Crupi
L
L
Trabattoni
D
D
Shearer
G M
GM
Clerici
M
M
D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016207:Cytokines / Q000097:blood*; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000276:immunology* / Q000635:transmission; D018023:HIV Seronegativity / Q000276:immunology; D015497:HIV-1; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D007136:Immunoglobulins / Q000097:blood; D018445:Infectious Disease Transmission, Vertical; D007963:Leukocytes, Mononuclear / Q000276:immunology; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets; D008297:Male
D016207:Cytokines; D007136:Immunoglobulins; D007073:Immunoglobulin E