在马拉维儿童中，艾滋病毒感染使与脑型疟疾相关的淋巴细胞减少症更加严重。

HIV infection compounds the lymphopenia associated with cerebral malaria in Malawian children.

作者信息

Mandala Wilson L, Gondwe Esther N, Nyirenda Tonney S, Drayson Mark, Molyneux Malcolm E, MacLennan Calman A

机构信息

Malawi Liverpool Wellcome Trust Clinical Research Programme, College of Medicine, Blantyre, Malawi,

Biomedical Sciences Department, College of Medicine, Blantyre, Malawi,

出版信息

J Blood Med. 2018 Dec 19;10:9-18. doi: 10.2147/JBM.S187081. eCollection 2019.

DOI:10.2147/JBM.S187081

PMID:30588141

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6305159/

Abstract

AIM

Cerebral malaria (CM), unlike severe malarial anemia (SMA), has previously been characterized by pan-lymphopenia that normalizes in convalescence, while HIV infection is associated with depletion of CD4 T cells. In this study, we investigate whether HIV infection in Malawian children exacerbates the pan-lymphopenia associated with CM.

METHODS

We investigated the absolute and percentage lymphocyte-subset counts and their activation and memory status in Malawian children presenting with either CM who were HIV-uninfected (n=29), HIV-infected (n=9), or SMA who were HIV-uninfected (n=30) and HIV-infected (n=5) in comparison with HIV-uninfected children without malaria (n=42) and HIV-infected children without malaria (n=4).

RESULTS

HIV-infected CM cases had significantly lower absolute counts of T cells (=0.006), CD4 T cells (=0.0008), and B cells (=0.0014) than HIV-uninfected CM cases, and significantly lower percentages of CD4 T cells than HIV-uninfected CM cases (=0.005). HIV-infected SMA cases had significantly lower percentages of CD4 T cells (=0.001) and higher CD8 T cells (=0.003) in comparison with HIV-uninfected SMA cases. HIV-infected SMA cases had higher proportions of activated T cells (=0.003) expressing CD69 than HIV-uninfected SMA cases.

CONCLUSION

HIV infection compounds the perturbation of acute CM and SMA on lymphocytes, exacerbating subset-specific lymphopenia in CM and increasing activation status in SMA, potentially exacerbating host immunocompromise.

摘要

目的

与严重疟疾贫血（SMA）不同，脑型疟疾（CM）以前的特征是全淋巴细胞减少，恢复期可恢复正常，而HIV感染与CD4 T细胞耗竭有关。在本研究中，我们调查马拉维儿童中的HIV感染是否会加剧与CM相关的全淋巴细胞减少。

方法

我们调查了未感染HIV的CM患儿（n = 29）、感染HIV的CM患儿（n = 9）、未感染HIV的SMA患儿（n = 30）和感染HIV的SMA患儿（n = 5）的淋巴细胞亚群绝对计数和百分比计数及其激活和记忆状态，并与未感染疟疾的未感染HIV儿童（n = 42）和未感染疟疾的感染HIV儿童（n = 4）进行比较。

结果

与未感染HIV的CM病例相比，感染HIV的CM病例的T细胞绝对计数（= 0.006）、CD4 T细胞绝对计数（= 0.0008）和B细胞绝对计数（= 0.0014）显著更低，CD4 T细胞百分比显著低于未感染HIV的CM病例（= 0.005）。与未感染HIV的SMA病例相比，感染HIV的SMA病例的CD4 T细胞百分比显著更低（= 0.001），CD8 T细胞更高（= 0.003）。与未感染HIV的SMA病例相比，感染HIV的SMA病例中表达CD69的活化T细胞比例更高（= 0.003）。