*Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; †Virology Laboratory, University Teaching Hospital, Lusaka, Zambia; ‡Center for Infectious Disease Research-Zambia, Lusaka, Zambia; §Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Alabama, AL; and ‖W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Dr Rainwater-Lovett is now with the Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD; Carolyn B. Moore is now with Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, NC).
J Acquir Immune Defic Syndr. 2014 Apr 15;65(5):505-9. doi: 10.1097/QAI.0000000000000074.
Antiretroviral therapy (ART) is associated with incomplete restoration of resting memory B (RMB) cell percentages in adults infected with HIV, but the effects on RMB cells in children are less well defined, in part because changes in RMB cell percentages are confounded by the development and maturation of the RMB cell pool. The objective of this study was to assess the effect of age at ART initiation on RMB cell percentages over time in HIV-infected Zambian children.
RMB cell percentages (CD19CD21CD27) were measured by flow cytometry in 146 HIV-infected Zambian children (9-120 months old) at baseline and at 3-month intervals after ART initiation and in 34 control children at a single study visit.
RMB cell percentages among untreated HIV-infected children younger than 24 months did not differ from those of control children (P = 0.97). Among HIV-infected children older than 24 months of age, however, each 12-month increase in age at ART initiation was associated with a 1.8% decrease in RMB cell percentage. In contrast, RMB cell percentages in control children up to 48 months increased 4.4% with each 12-month increase in age. After 12 months of ART, children aged 24-60 months had a significant increase in RMB cell percentages that no longer differed from those of control children.
Initiation of ART in 2- to 5-year-old HIV-infected children resulted in reconstitution of RMB cell percentages to levels similar to control children and may help restore normal development and maintenance of B-cell immunity.
抗逆转录病毒疗法（ART）与成人感染 HIV 后静止记忆 B（RMB）细胞百分比的不完全恢复有关，但对儿童 RMB 细胞的影响则不太明确，部分原因是 RMB 细胞百分比的变化与 RMB 细胞池的发育和成熟有关。本研究的目的是评估在 HIV 感染的赞比亚儿童中，ART 开始时的年龄对 RMB 细胞百分比随时间的影响。
通过流式细胞术测量 146 名 HIV 感染的赞比亚儿童（9-120 个月龄）在开始 ART 时的基线和 3 个月间隔以及 34 名对照儿童在单次研究访视时的 RMB 细胞百分比。
未接受治疗的 HIV 感染的年龄小于 24 个月的儿童的 RMB 细胞百分比与对照组儿童无差异（P = 0.97）。然而，在年龄大于 24 个月的 HIV 感染儿童中，ART 开始时的年龄每增加 12 个月，RMB 细胞百分比则下降 1.8%。相比之下，年龄在 24-48 个月的对照儿童的 RMB 细胞百分比在每个 12 个月的增长期内增加了 4.4%。在接受 12 个月的 ART 治疗后，24-60 个月龄的儿童 RMB 细胞百分比显著增加，与对照组儿童无差异。
在 2-5 岁的 HIV 感染儿童中开始 ART 治疗可使 RMB 细胞百分比恢复到与对照组儿童相似的水平，这可能有助于恢复 B 细胞免疫的正常发育和维持。
