Children, especially boys, born to women with HIV infection have an increased risk of immune abnormalities, including a high risk of death, finds a study.
This is because of exposure to maternal HIV viruses in the blood,
immune dysfunction, and co-infections during pregnancy revealed by the team
from the Queen Mary University of London in the UK.
The study included 726 pregnant women with HIV, and compared blood
samples between infants who were HIV-exposed and HIV-unexposed in rural
Zimbabwe. The findings showed that the immune development of HIV-exposed babies
-- and especially boys -- was different in those who had been exposed.
Mortality rates in this group were 41 per cent higher than in
infants not exposed to HIV.
"Collectively, the findings show how the skewed immune milieu
of women with HIV in pregnancy -- characterised by inflammation, immune
dysfunction, and co-infections -- shapes immune development in their
offspring," said Dr. Ceri Evans, Clinical Lecturer in Paediatric
Infectious Diseases at the University of Liverpool.
Even among the infants who survived and remained HIV-free, the
team found impaired growth and development. Worryingly, this is "despite
high coverage of maternal antiretroviral therapy (ART) and uptake of exclusive
breastfeeding", the researchers said, in the paper published in the
journal Nature Communications. Besides systemic inflammation among women with
HIV, as measured by C-reactive protein (CRP) in the blood, infection with
cytomegalovirus (CMV) -- a co-factor in HIV disease progression -- was also
found to be independently associated with infant mortality, as well as
impacting on the development of the child's immune system, the researchers
explained.
"Inflammation, as indicated by CRP, is inexpensive and simple
to measure, offering the immediate opportunity for antenatal point-of-care
testing to be used to identify those most at risk of infant mortality, with
more support provided for high-risk pregnancies," Evans said.
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