Abstract
Understanding the defects in innate immunity associated with perinatal
HIV infection is prerequisite for the effective antiretroviral treatment. We
therefore compared the innate immune response (Dendritic cell (DC) phenotype and
function in peripheral blood by flow cytometry at baseline and 12 months in HIV
infected children in order to determine the defect associated with perinatal HIV
infection. As compared to controls patients had decreased numbers of total DC
including plasmacytoid (p)DC and myeloid (m)DC and impaired function based on
induction of maturation markers (CD83, CD80, CCR7) and cytokines TNF-α
and IFN-α (exclusive to pDC) upon stimulation with TLR7/8 agonist
Resiquimod. These abnormalities were evident in all three CD4 immune categories
and persisted over 12 months; pDC function worsened in HIV+ children without
treatment and improved slightly in those on HAART. In conclusion, a majority of
perinatally HIV-infected older children without HAART remain clinically stable
in the short term, but have demonstrable immunologic abnormalities indicative of
defects in the innate immune system. Children initiated on HAART showed
improvement in CD4 counts but didn’t show improvement in DC function
over the short term.
