Department of Pediatrics, University of Alberta, Edmonton, Canada.
Unité d'immunopathologie Virale, Centre de Recherche du CHU Sainte-Justine, Montréal, Canada.
J Acquir Immune Defic Syndr. 2024 Sep 1;97(1):78-86. doi: 10.1097/QAI.0000000000003467.
To investigate the association between African ancestry and neutrophil counts among children living with HIV (CLWH). We also examined whether medications, clinical conditions, hospitalization, or HIV virologic control were associated with low neutrophil counts or African ancestry.
We conducted a secondary analysis of the Early Pediatric Initiation Canada Child Cure Cohort (EPIC4) Study, a multicenter prospective cohort study of CLWH across 8 Canadian pediatric HIV care centers.
We classified CLWH according to African ancestry, defined as "African," "Caribbean," or "Black" maternal race. Longitudinal laboratory data (white blood cells, neutrophils, lymphocytes, viral load, and CD4 count) and clinical data (hospitalizations, AIDS-defining conditions, and treatments) were abstracted from medical records.
Among 217 CLWH (median age 14, 55% female), 145 were of African ancestry and 72 were of non-African ancestry. African ancestry was associated with lower neutrophil counts, white blood cell counts, and neutrophil-lymphocyte ratios. Neutrophil count <1.5 × 109/L was detected in 60% of CLWH of African ancestry, compared with 31% of CLWH of non-African ancestry (P < 0.0001), representing a 2.0-fold higher relative frequency (95% CI: 1.4-2.9). Neutrophil count was on average 0.74 × 109/L (95% CI: 0.45 to 1.0) lower in CLWH of African ancestry (P < 0.0001). Neither neutrophil count<1.5 × 109/L nor African ancestry was associated with medications, hospitalizations, AIDS-defining conditions, or markers of virologic control (viral load, sustained viral suppression, and lifetime nadir CD4).
In CLWH, African ancestry is associated with lower neutrophil counts, without clinical consequences. A flexible evaluation of neutrophil counts in CLWH of African ancestry may avoid unnecessary interventions.
研究非洲血统与感染人类免疫缺陷病毒（HIV）的儿童（CLWH）中性粒细胞计数之间的关系。我们还研究了药物、临床状况、住院或 HIV 病毒学控制是否与低中性粒细胞计数或非洲血统有关。
我们对加拿大儿童治愈早期儿科启动 4 期（EPIC4）研究进行了二次分析，这是一项在加拿大 8 个儿科 HIV 护理中心进行的 CLWH 多中心前瞻性队列研究。
我们根据非洲血统将 CLWH 分类，定义为“非洲人”、“加勒比人”或“黑人”母亲种族。从病历中提取了纵向实验室数据（白细胞、中性粒细胞、淋巴细胞、病毒载量和 CD4 计数）和临床数据（住院、艾滋病定义的疾病和治疗）。
在 217 名 CLWH 中（中位数年龄为 14 岁，55%为女性），145 名是非洲血统，72 名是非非洲血统。非洲血统与较低的中性粒细胞计数、白细胞计数和中性粒细胞-淋巴细胞比值有关。非洲血统的 CLWH 中有 60%的中性粒细胞计数<1.5×109/L，而非非洲血统的 CLWH 中只有 31%（P<0.0001），相对频率高 2.0 倍（95%CI：1.4-2.9）。非洲血统的 CLWH 中性粒细胞计数平均低 0.74×109/L（95%CI：0.45-1.0）（P<0.0001）。中性粒细胞计数<1.5×109/L 和非洲血统均与药物、住院、艾滋病定义的疾病或病毒学控制的标志物（病毒载量、持续病毒抑制和终生最低 CD4）无关。
在 CLWH 中，非洲血统与较低的中性粒细胞计数有关，但无临床后果。对非洲血统的 CLWH 进行灵活的中性粒细胞计数评估可能避免不必要的干预。
