Clinic of Infectious Diseases and Tropical Medicine, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan.
Division of Paediatric Oncology-Haematology, Policlinico Hospital, Modena.
AIDS. 2022 Nov 15;36(14):1917-1925. doi: 10.1097/QAD.0000000000003324. Epub 2022 Jul 22.
HIV-exposed infected (HEI) and uninfected (HEU) children represent the two possible outcomes of maternal HIV infection. Modifications of the intestinal microbiome have been linked to clinical vulnerability in both settings, yet whether HEI and HEU differ in terms of gut impairment and peripheral inflammation/activation is unknown.
We performed a cross-sectional, pilot study on fecal and plasma microbiome as well as plasma markers of gut damage, microbial translocation, inflammation and immune activation in HIV-infected and uninfected children born from an HIV-infected mother.
Fecal and plasma microbiome were determined by means of 16S rDNA amplification with subsequent qPCR quantification. Plasma markers were quantified via ELISA.
Forty-seven HEI and 33 HEU children were consecutively enrolled. The two groups displayed differences in fecal beta-diversity and relative abundance, yet similar microbiome profiles in plasma as well as comparable gut damage and microbial translocation. In contrast, monocyte activation (sCD14) and systemic inflammation (IL-6) were significantly higher in HEI than HEU.
In the setting of perinatal HIV infection, enduring immune activation and inflammation do not appear to be linked to alterations within the gut. Given that markers of activation and inflammation are independent predictors of HIV disease progression, future studies are needed to understand the underlying mechanisms of such processes and elaborate adjuvant therapies to reduce the clinical risk in individuals with perinatal HIV infection.
HIV 暴露感染（HEI）和未感染（HEU）儿童代表了母婴 HIV 感染的两种可能结果。肠道微生物组的改变与这两种情况下的临床脆弱性有关，但 HEI 和 HEU 在肠道损伤和外周炎症/激活方面是否存在差异尚不清楚。
我们对来自 HIV 感染母亲的 HIV 感染和未感染儿童进行了横断面、试点研究，检测粪便和血浆微生物组以及血浆肠道损伤、微生物易位、炎症和免疫激活的标志物。
通过 16S rDNA 扩增和随后的 qPCR 定量来确定粪便和血浆微生物组。通过 ELISA 定量血浆标志物。
连续纳入了 47 名 HEI 和 33 名 HEU 儿童。两组粪便β多样性和相对丰度存在差异，但血浆微生物组谱相似，肠道损伤和微生物易位也相似。相反，单核细胞活化（sCD14）和全身炎症（IL-6）在 HEI 中明显高于 HEU。
在围产期 HIV 感染的情况下，持续的免疫激活和炎症似乎与肠道内的改变无关。鉴于激活和炎症标志物是 HIV 疾病进展的独立预测因子，未来的研究需要了解这些过程的潜在机制，并制定辅助治疗方法，以降低围产期 HIV 感染个体的临床风险。
