Research Highlights: High immune cell count associated with low IQ in children with HIV

Original Article:

  • The human immunodeficiency virus (HIV) is an enveloped retrovirus that contains 2 copies of a single-stranded RNA genome.
  • HIV causes the acquired immunodeficiency syndrome (AIDS) that is the last stage of HIV disease.
  • HIV causes neurocognitive impairment possibly by transmigration through the blood brain barrier of activated T cells and infected monocytes triggering a cascade of inflammatory processes
  • HIV encephalopathy, a severe form of neurocognitive impairment in children, has become less common since antiretroviral therapy (ART) became widely available.
  • However, chronic stable cognitive and behavioral deficits remain, predicting academic impairments in school.
  • Limited studies in US children have suggested that certain lymphocyte subsets may predict poorer cognition
  • This study assesses the relationships between lymphocyte and monocyte subsets and intelligence quotient (IQ) scores in antiretroviral therapy (ART)-naive, HIV-infected Thai children without advanced HIV disease.
  • Sixty-seven ART-naive Thai children with CD4 between 15-24% underwent cognitive testing by Weschler intelligence scale and had 13 cell subsets performed by flow cytometry including naive, memory and activated subsets of CD4+ and CD8+ T cells, activated and perivascular monocytes and B cells.
  • Regression modelling with log10 cell count and cell percentage transformation was performed.
  • High B cell counts and percentages were strongly associated with poorer FIQ, VIQ and PIQ scores.
  • Prospective, long-term assessment of cell subsets and determination of relevant B cell subpopulations could help further elucidate associations between lymphocyte subsets and neurocognitive development.


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Puthanakit T, Ananworanich J, Vonthanak S, Kosalaraksa P, Hansudewechakul R, van der Lugt J, Kerr SJ, Kanjanavanit S, Ngampiyaskul C, Wongsawat J, Luesomboon W, Vibol U, Pruksakaew K, Suwarnlerk T, Apornpong T, Ratanadilok K, Paul R, Mofenson LM, Fox L, Valcour V, Brouwers P, Ruxrungtham K: Cognitive function and neurodevelopmental outcomes in HIV-infected children older than 1 year of age randomized to early versus deferred antiretroviral therapy: the PREDICT neurodevelopmental study. Pediatr Infect Dis J. 2013, 32 (5): 501-508.

Mekmullica J, Brouwers P, Charurat M, Paul M, Shearer W, Mendez H, Diaz C, Read JS, Mondal P, Smith R, McIntosh K: Early immunological predictors of neurodevelopmental outcomes in HIV-infected children. Clin Infect Dis. 2009, 48: 338-346.

Kapetanovic S, Aaron L, Montepiedra G, Burchett SK, Kovacs A: T-cell activation and neurodevelopmental outcomes in perinatally HIV-infected children. AIDS. 2012, 26: 959-969.

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