Novel HIV-1 Recombinant Forms in Antenatal Cohort, Montreal, Quebec, Canada

Near full-length genomes of 4 unclassified HIV-1 variants infecting patients enrolled in an antenatal cohort in Canada were obtained by sequencing. All 4 variants showed original recombination profiles, including A1/A2/J, A1/D, and A1/G/J/CRF11_cpx structures. Identification of these variants highlights the growing prevalence of unique recombinant forms of HIV-1 in North America

Immunité maternelle et transmission mère-enfant du VIH et du VHC

Le virus de l’immunodéficience humaine (VIH) et le virus de l’hépatite C (VHC), deux pathogènes viraux qui provoquent et installent une infection chronique chez leur hôte, sont à l’origine de graves problèmes de santé publique à l’échelle planétaire. Le VIH et le VHC sont transmissibles de la mère à l’enfant durant la grossesse et l’accouchement, et aucun vaccin ne permet encore à l’heure actuelle de prévenir ces infections. D’importants progrès ont cependant jalonné le chemin parcouru depuis la découverte de ces virus : (1) des méthodes de dépistage et de diagnostic efficaces ont été développées ; (2) plusieurs éléments du cycle réplicatif, de la pathogénie et des mécanismes de transmission ont été caractérisés ; (3) des protocoles spécifiques de prophylaxie antirétrovirale et d’immunothérapie ont été établis ; et (4) les corrélats d’immunité sont maintenant mieux compris. Ces progrès permettent d’entrevoir le déploiement de stratégies efficaces pour prévenir la transmission mèreenfant au niveau globa

The Young and the Resistant:HIV-Infected Adolescents at the Time of Transfer to adult Care

Combined antiretroviral therapy allows children with human immunodeficiency virus (HIV) to reach adulthood. We studied 45 adolescents at the time of transfer to adult care. Despite universal healthcare access, over two-thirds of the adolescents were failing treatment, which was manifested by detectable HIV-1 viral load, CD4 counts <200 cells/ mm3, and/or triple-class drug resistance

Chitinase-3-like Protein 1 Is Associated with Poor Virologic Control and Immune Activation in Children Living with HIV

Perinatally infected children living with HIV (CLWH) face lifelong infection and associated inflammatory injury. Chitinase-like 3 protein-1 (CHI3L1) is expressed by activated neutrophils and may be a clinically informative marker of systemic inflammation in CLWH. We conducted a multi-centre, cross-sectional study of CLWH, enrolled in the Early Pediatric Initiation Canadian Child Cure Cohort Study (EPIC4). Plasma levels of CHI3L1, pro-inflammatory cytokines, and markers of microbial translocation were measured by enzyme-linked immunosorbent assays. Longitudinal clinical characteristics (viral load, neutrophil count, CD4+ and CD8+ T-lymphocyte counts, and antiretroviral (ARV) regimen) were abstracted from patient medical records. One-hundred-and-five (105) CLWH (median age 13 years, 62% female) were included in the study. Seventy-seven (81%) had viral suppression on combination antiviral therapy (cART). The median CHI3L1 level was 25 &mu;g/L (IQR 19&ndash;39). CHI3L1 was directly correlated with neutrophil count (&rho; = 0.22, p = 0.023) and inversely correlated with CD4/CD8 lymphocyte ratio (&rho; = &minus;0.35, p = 0.00040). Children with detectable viral load had higher levels of CHI3L1 (40 &mu;g/L (interquartile range, IQR 33&ndash;44) versus 24 &mu;g/L (IQR 19&ndash;35), p = 0.0047). CHI3L1 levels were also correlated with markers of microbial translocation soluble CD14 (&rho; = 0.26, p = 0.010) and lipopolysaccharide-binding protein (&rho; = 0.23, p = 0.023). We did not detect differences in CHI3L1 between different cART regimens. High levels of neutrophil activation marker CHI3L1 are associated with poor virologic control, immune dysregulation, and microbial translocation in CLWH on cART