2024-09-11 07:43:52
Recently, at the AIDS 2024 conference, researchers presented two studies revealing that Infants born to HIV-positive mothers who were not infected themselves may have poorer health than othersTheir intestinal virome would indeed be altered and their immune response reduced. We take stock.
HIV-exposed and uninfected infants: affected health?
Table of Contents
Table of Contents
While we can be pleased about the significant drop in the number of children newly infected with the HIV in recent years (-62% between 2010 and 2023), it would seem that children exposed to HIV and not infected nevertheless present an altered state of health.
This is what they suggest two scientific studies presented at the AIDS 2024 conference in Munich last July. Children exposed to HIV and not infected would indeed suffer increased morbidity and mortality compared to children not infected and not exposed to HIV.
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An altered intestinal virome
Although antiretroviral treatments have improved the health of HIV-positive mothers and ensured safer breastfeeding, the virus is still responsible for a change in the composition of breast milk.
Based on this observation, Californian scientists looked into the impact of the virome present in breast milk on the intestinal virome of infants one-week-old, HIV-exposed and uninfected.
Good to know! The intestinal virome refers to all the viruses present in the intestine.
To carry out their work, the researchers compared two groups of women:
A group of 40 HIV-positive women and their uninfected newborns. And a group of 40 HIV-negative women and their newborns.
They thus noted a alteration of the intestinal virome of HIV-exposed and uninfected children. The number of viruses infecting bifidobacteria (bacteria of the intestinal flora) in the first week of life has in fact been multiplied by 11, resulting in a reduction of a factor of 24 in the population of these bacteria. And this reduction proves to be harmful in the sense that the abundance of bifidobacteria in the first week of life is positively linked to a better response to the BCG vaccine against tuberculosis.
Good to know! Viruses that infect bacteria are called “bacteriophages” and are very numerous within the microbiota. They are part of the “virome” and can modify bacterial populations, their genetic heritage and the expression of the microbiota.
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A reduced immune response
Furthermore, it would seem that the immunity of HIV-exposed and uninfected children is also reducedWhile previous studies have already demonstrated their poor response to pediatric vaccinations, a new Nigerian study has looked at the effects of tetanus vaccination in these children.
This is how 61 HIV-unexposed infants and 144 HIV-exposed and uninfected infants were followed. Their IgG antibodies were measured at birth (mother-child pairs) and at 15 weeks of age (single children) after pediatric vaccination (consisting of three doses to be injected at 6, 10 and 14 weeks of life according to the Nigerian tetanus vaccination program). The result is a weakened response to tetanus vaccine with a median transfer of maternal IgG antibodies in HIV-exposed, uninfected infants reduced by 12% compared with unexposed children. And at 15 weeks of age, their tetanus IgG levels were significantly lower than those of unexposed children.
For scientists, these observations testify to the need to optimize vaccine response in HIV-exposed and uninfected childrenProviding them with additional doses could therefore be a possible option.
Read also – HIV/AIDS: first woman cured thanks to umbilical cord blood
Deborah L., Doctor of Pharmacy
Sources
– HIV: intestinal virome and immunity are altered in exposed, uninfected infants. www.lequotidiendumedecin.fr. Accessed September 12, 2024.
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HIV-Exposed Uninfected Infants: Understanding Their Poorer Health and Reduced Immune Response
Recent studies presented at the AIDS 2024 conference have shed light on the health concerns of infants born to HIV-positive mothers who are not infected themselves. Despite the significant drop in new HIV infections in children over the past decade (-62% between 2010 and 2023), HIV-exposed uninfected (HEU) infants may still experience poorer health and reduced immune responses compared to their non-exposed peers.
An Altered Intestinal Virome
Research has shown that the viral composition of breast milk in HIV-positive mothers can alter the intestinal virome of their infants [[3]]. The intestinal virome refers to the collection of viruses present in the intestine. California-based scientists compared the intestinal virome of 40 HIV-positive women and their uninfected newborns to that of 40 HIV-negative women and their newborns. They found an alteration in the intestinal virome of HEU children, with an 11-fold increase in viruses infecting bifidobacteria (beneficial bacteria in the intestinal flora) in the first week of life. This reduction in bifidobacteria population is harmful, as it is positively linked to a better response to the BCG vaccine against tuberculosis.
A Reduced Immune Response
Further studies have demonstrated that HEU children may also have a reduced immune response. A Nigerian study examined the effects of tetanus vaccination in HEU children and found a weakened response to the vaccine [[1][2]]. The study followed 61 HIV-unexposed infants and 144 HIV-exposed uninfected infants, measuring their IgG antibodies at birth and at 15 weeks of age after vaccination. The results showed a 12% reduction in the median transfer of maternal IgG antibodies in HEU infants compared to unexposed children. At 15 weeks of age, their tetanus IgG levels were significantly lower than those of unexposed children.
Critical Immune Defects in HEU Infants
Research has mapped out critical immune defects in HEU infants, including defects in pathogen sensing and recognition, oxidative burst, and antigen-specific responses [[1][2]]. These defects may contribute to their reduced immune response and increased morbidity and mortality rates compared to non-exposed children.
The Need for Optimized Vaccine Response
The findings of these studies highlight the need to optimize vaccine response in HEU children. With the number of uninfected children born to mothers with HIV increasing, reaching over 14 million in 2017 [[3]], it is essential to address their unique health needs and develop effective strategies to improve their immune responses.
infants born to HIV-positive mothers who are not infected themselves may experience poorer health and reduced immune responses due to an altered intestinal virome and critical immune defects. Further research is necessary to understand the underlying mechanisms and to develop effective interventions to optimize their health outcomes.
IAS Conference 2024
HIV-Exposed and Uninfected Infants: Understanding Their Poorer Health and Reduced Immune Response
The AIDS 2024 conference in Munich recently presented two studies that revealed a shocking truth: infants born to HIV-positive mothers who were not infected themselves may have poorer health than others. These infants, known as HIV-exposed and uninfected (HEU) infants, have an altered intestinal virome and a reduced immune response. In this article, we will delve into the details of these studies and explore the implications of their findings.
HIV-Exposed and Uninfected Infants: Affected Health?
Despite the significant drop in the number of children newly infected with HIV in recent years (-62% between 2010 and 2023), HIV-exposed and uninfected infants still present an altered state of health. Two scientific studies presented at the AIDS 2024 conference suggest that these infants suffer from increased morbidity and mortality compared to children not infected and not exposed to HIV.
An Altered Intestinal Virome
Although antiretroviral treatments have improved the health of HIV-positive mothers and ensured safer breastfeeding, the virus is still responsible for a change in the composition of breast milk. Californian scientists looked into the impact of the virome present in breast milk on the intestinal virome of infants one-week-old, HIV-exposed and uninfected. They compared two groups of women: 40 HIV-positive women and their uninfected newborns, and 40 HIV-negative women and their newborns.
The researchers found that the number of viruses infecting bifidobacteria (bacteria of the intestinal flora) in the first week of life was multiplied by 11, resulting in a reduction of a factor of 24 in the population of these bacteria. This reduction proves to be harmful, as the abundance of bifidobacteria in the first week of life is positively linked to a better response to the BCG vaccine against tuberculosis. [[1]]
A Reduced Immune Response
Furthermore, the immunity of HIV-exposed and uninfected children is also reduced. While previous studies have already demonstrated their poor response to pediatric vaccinations, a new Nigerian study looked at the effects of tetanus vaccination in these children. The study found that HIV-exposed and uninfected infants had lower levels of antibodies against tetanus compared to HIV-unexposed infants. [[3]]
Additionally, another study found that HIV-infected mothers at delivery had significantly higher levels of sTNF-RI, IL-6, sCD14, and hsCRP compared to HIV-uninfected mothers. These inflammatory markers are associated with a reduced immune response in HIV-exposed and uninfected infants. [[1]]
Understanding the Implications
The findings of these studies have significant implications for the health and well-being of HIV-exposed and uninfected infants. It is essential to understand that these infants may require additional healthcare interventions to prevent and treat illnesses, as well as to improve their immune response to vaccinations.
Moreover, the altered intestinal virome and reduced immune response of HIV-exposed and uninfected infants may increase their susceptibility to opportunistic infections, such as P. jirovecii pneumonia, which is typically seen in HIV-infected infants.[[[2]]
Conclusion
the studies presented at the AIDS 2024 conference highlight the importance of monitoring and addressing the health needs of HIV-exposed and uninfected infants. Despite their HIV-free status, these infants are at risk of poorer health outcomes and reduced immune responses, which can have long-term consequences for their health and well-being.
It is crucial for healthcare providers, researchers, and policymakers to work together to develop and implement strategies to improve the health outcomes of HIV-exposed and uninfected infants, and to ensure that they receive the necessary care and support to thrive.
References:
[1]
[2]
[3] <https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(19)304
