Long-term impact of ART on immune status of HIV-infected children

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K10100
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Pediatrics
• Research Institution: Kanazawa University
• Principal Investigator: BI Xiuqiong 金沢大学, 医学系, 助教 (50565413)
• Co-Investigator(Kenkyū-buntansha): 市村 宏 金沢大学, 医学系, 教授 (10264756)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: HIV / ART / 小児 / 免疫状態

Outline of Final Research Achievements

This study investigated the impact of ART on the immune status of HIV-infected Vietnamese children. The differentiation of CD4 and CD8 cells, Th1/Th2/Th17/Treg subsets, and CD8 T cell activation were analyzed twice a year and compared to those of HIV-uninfected children.
After ART initiation, the CD4 cell counts including the CD4-RTE (recent thymic emigrants)/-naive/-cm (central memory)/-em (effector memory) and Th1 subsets, and the CD8-naive/-cm subset counts significantly increased and reached the HIV(─) children’s range by 6 months. The CD4-emra (emCD45RA+) and Th2/Th17/Treg, the activated CD8 cells, the CD8-em/-emra subsets, the CD4/CD8 ratio normalized within 4 years. The younger children showed better increase of CD4 counts at 6 months of ART. ART induced an early recovery of thymic function in HIV-infected children and lead to the early recovery of CD4 and CD8 naive subsets. Early diagnose of HIV infection followed by early ART is important for HIV administration in children.

Free Research Field

ウイルス感染症

Academic Significance and Societal Importance of the Research Achievements

本研究では、ベトナムの小児において、HIV感染小児の免疫状態が生後1-2か月から胸腺機能を含む異常状態になっていたことが示された。また、ART開始後、胸腺機能は６ヶ月までに回復し、CD4とCD8のnaive サブセットとTh1も早期に回復したが、他のCD4とCD8細胞のサブセットとCD8　T細胞の活性化の正常化は1-4年の治療が必要であった。更に、ART開始前の年齢は小さく、CD4細胞数が高いほどART開始後6ヶ月のCD4細胞増加数が多く、回復がよかった。小児において、HIV感染の早期診断、そしてARTの早期導入がHIV感染管理に重要である。