Immune development in HIV-exposed uninfected children born to HIV-infected women

Immunological and clinical findings suggestive of some immune dysfunction have been reported among HIV-exposed uninfected (HEU) children and adolescents. Whether these defects are persistent or transitory is still unknown. HEU pediatric population at birth, 12 months, 6-12 years were evaluated in comparison to healthy age-matched HIV-unexposed controls. Plasma levels of LPS, sCD14, cytokines, lymphocyte immunophenotyping and T-cell receptor excision circles (TREC) were assessed. HEU and controls had similar LPS levels, which remained low from birth to 6-12 years; for plasma sCD14, IL-2, IL-6, IL-7, IL-10, IL-12p70, IL-13, IL-17, IFN-γ, TNF-α, G-CSF, GM-CSF and MCP-1, which increased from birth to 12 months and then decreased at 6-12 years; and for TREC/106 PBMC at birth in HEU and controls. By contrast, plasma MIP-1β levels were lower in HEU than in controls (p=0.009) at 12 months, and IL-4 levels were higher in HEU than controls (p=0.04) at 6-12 years. Immune activation was higher in HEU at 12 months and at 6-12 years than controls based on frequencies of CD38+HLA-DR+CD8+T cells (p=0.05) and of CD38+HLA-DR+CD4+T cells (p=0.006). Resting memory and activated mature B cells increased from birth to 6-12 years in both groups. The development of the immune system in vertically HEU individuals is comparable to the general population in most parameters, but subtle or transient differences exist. Their role in influencing clinical incidences in HEU is unknown

Emerging Infections and Pertinent Infections Related to Travel for Patients with Primary Immunodeficiencies

Erratum: J Clin Immunol. 2017 Oct;37(7):693-694. doi: 10.1007/s10875-017-0436-0.In today's global economy and affordable vacation travel, it is increasingly important that visitors to another country and their physician be familiar with emerging infections, infections unique to a specific geographic region, and risks related to the process of travel. This is never more important than for patients with primary immunodeficiency disorders (PIDD). A recent review addressing common causes of fever in travelers provides important information for the general population Thwaites and Day (N Engl J Med 376:548-560, 2017). This review covers critical infectious and management concerns specifically related to travel for patients with PIDD. This review will discuss the context of the changing landscape of infections, highlight specific infections of concern, and profile distinct infection phenotypes in patients who are immune compromised. The organization of this review will address the environment driving emerging infections and several concerns unique to patients with PIDD. The first section addresses general considerations, the second section profiles specific infections organized according to mechanism of transmission, and the third section focuses on unique phenotypes and unique susceptibilities in patients with PIDDs. This review does not address most parasitic diseases. Reference tables provide easily accessible information on a broader range of infections than is described in the text.Peer reviewe

Lymphocyte subsets in human immunodeficiency virus-unexposed Brazilian individuals from birth to adulthood

Ethnic origin, genetics, gender and environmental factors have been shown to influence some immunologic indices, so that development of reference values for populations of different backgrounds may be necessary. We have determined the distribution of lymphocyte subsets in healthy Brazilian individuals from birth to adulthood. Lymphocyte subsets were determined using four-colour cytometry in a cross-sectional study of 463 human immunodeficiency virus-unexposed children and adults from birth through 49 years of age. Lymphocyte subsets varied according to age, as previously observed in other studies. However, total CD4+ T cell numbers were lower than what was described in the Pediatric AIDS Clinical Trials Group P1009 (PACTG P1009), which assessed an American population of predominantly African and Hispanic backgrounds until the 12-18 year age range, when values were comparable. Naïve percentages and absolute values of CD8+ T cells, as assessed by CD45RA expression, were also lower than the PACTG P1009 data for all analysed age ranges. CD38 expression on both CD4+ and CD8+ T cells was lower than the PACTG P1009 values, with a widening gap between the two studies at older age ranges. Different patterns of cell differentiation seem to occur in different settings and may have characteristic expression within each population.Universidade Federal de São Paulo (UNIFESP) Departamento de MedicinaCentro Assistencial Cruz de MaltaUniversidade Federal de São Paulo (UNIFESP) Departamento de PediatriaUNIFESP, Depto. de MedicinaUNIFESP, Depto. de PediatriaSciEL

PROTECTIVE LEVELS OF VARICELLA-ZOSTER ANTIBODY DID NOT EFFECTIVELY PREVENT CHICKENPOX IN AN X-LINKED AGAMMAGLOBULINEMIA PATIENT

SUMMARY We describe the case of an eight-year-old boy with X-linked agammaglobulinemia who developed mild varicella despite regular intravenous immunoglobulin (IVIG) therapy. He maintained protective antibody levels against varicella and the previous batches of IVIG that he received had adequate varicella-specific IgG levels. The case illustrates that IVIG may not prevent VZV infection

Strong HIV-1-Specific T Cell Responses in HIV-1-Exposed Uninfected Infants and Neonates Revealed after Regulatory T Cell Removal

BACKGROUND: In utero transmission of HIV-1 occurs on average in only 3%–15% of HIV-1-exposed neonates born to mothers not on antiretroviral drug therapy. Thus, despite potential exposure, the majority of infants remain uninfected. Weak HIV-1-specific T-cell responses have been detected in children exposed to HIV-1, and potentially contribute to protection against infection. We, and others, have recently shown that the removal of CD4(+)CD25(+) T-regulatory (Treg) cells can reveal strong HIV-1 specific T-cell responses in some HIV-1 infected adults. Here, we hypothesized that Treg cells could suppress HIV-1-specific immune responses in young children. METHODOLOGY/PRINCIPAL FINDINGS: We studied two cohorts of children. The first group included HIV-1-exposed-uninfected (EU) as well as unexposed (UNEX) neonates. The second group comprised HIV-1-infected and HIV-1-EU children. We quantified the frequency of Treg cells, T-cell activation, and cell-mediated immune responses. We detected high levels of CD4(+)CD25(+)CD127(−) Treg cells and low levels of CD4(+) and CD8(+) T cell activation in the cord blood of the EU neonates. We observed HIV-1-specific T cell immune responses in all of the children exposed to the virus. These T-cell responses were not seen in the cord blood of control HIV-1 unexposed neonates. Moreover, the depletion of CD4(+)CD25(+) Treg cells from the cord blood of EU newborns strikingly augmented both CD4(+) and CD8(+) HIV-1-specific immune responses. CONCLUSIONS/SIGNIFICANCE: This study provides new evidence that EU infants can mount strong HIV-1-specific T cell responses, and that in utero CD4(+)CD25(+) T-regulatory cells may be contributing to the lack of vertical transmission by reducing T cell activation

NOTAS E RESENHAS

PIERRE MONBEIG, O PATRIARCA DA GEOGRAFIA PAULISTA E NACIONAL - Silvio Carlos BRAY FORMAÇÃO DE GEÓGRAFOS NA REPÚBLICA DEMOCRÁTICA ALEMÃ - Sylvio C. BANDEIRA DE MELLO E SILVA IMPACTO AMBIENTAL NA REGIÃO DE BRASILIA: AS CASCALHEIRAS - Maria NOVAES PINTO; Luiz Gonzaga FONSECA; Fernando MONTEIRO RIBEIRO IMPORTÂNCIA DO MONITORAMENTO EM AREAS AGRÍCOLAS - Miguel Cezar SANCHEZ; Nanci Aparecida VISACCHERO ANÁLISE DA QUALIDADE HÍDRICA PELA APLICAÇÃO DE BIO-INDICADORES (Contribuição aos Estudos Biogeográficos de Ambientes Aquáticos) - Adler G. VIADANA O TRABALHO INFORMAL NAS METRÓPOLES BRASILEIRAS: UMA ANÁLISE COMPARATIVA - Pedro DE ALMEIDA VASCONCELOS A VARIABILIDADE DAS TEMPERATURAS EM FUNÇÃO DE CARACTERÍSTICAS DAS VERTENTES - Anderson Luis HEBLING CHRISTOFOLETTI; Maria Juraci ZANI DOS SANTOS; Nádia Regina DO NASCIMENTO MIGRAÇÃO INTRA-URBANA: ALGUNS PROBLEMAS PARA A IMPLEMENTAÇÃO DE PROJETOS DE INVESTIGAÇÃO - Odeibler SANTO GUIDUGLI GEOGRAFIA INDUSTRIAL - Silvia SELINGARDI SAMPAIO DA VIDA BUCÓLICA AO USO DO SOLO E EXPLORAÇÃO DOS RECURSOS NATURAIS - Antonio CHRISTOFOLLETTI PROCESSOS POLÍTICOS E SÓCIO-ECONÔMICOS ATUANTES NA ORGANIZAÇÃO DOS SISTEMAS ESPACIAIS - Antonio CHRISTOFOLLETTI PROBLEMÁTICAS FOCALIZADAS EM GEOGRAFIA URBANA - Antonio CHRISTOFOLLETTI GEOGRAFIA DA POPULAÇÃO - Odeibler SANTO GUIDUGLI APLICAÇÕES HIDROLÓGICAS DA TECNOLOGIA ESPACIAL - Maria Isabel C. DE FREITAS RECURSOS ECONÔMICOS - Lucy Marion CALDERINI PHILADELPHO MACHADO AVALIAÇÃO ECONÔMICA DO MEIO AMBIENTE, SISTEMAS NATURAIS E DESENVOLVIMENTO - Ana Tereza CORTEZ MORAES BIOGEOGRAFIA E MEIO AMBIENTE - Walter Cecílio BRINO A TRANSIÇÃO TECNOLÓGICA EM CARTOGRAFIA - Miguel Cezar SANCHEZ MACMILLAN DICTIONARY OF THE ENVIRONMENT - Rolando BERRÍOS EARTH SCIENCE (PUPIL EDITION) - M. O. UMENWEKE EARTH SCIENCE (TEACHER EDlTION) - M. O. UMENWEK