Phenotype and function of B cells in children infected with human immunodeficiency vius

Muema, Daniel Kyuson Muli (2014). Phenotype and function of B cells in children infected with human immunodeficiency vius. PhD thesis The Open University.



HIV infection has been shown to affect all lymphocyte populations, including the B-cell compartment. Defects in phenotype and function of B cells have been well characterized in HIV -infected adults. However, only a few studies have investigated the effect of HIV on the B-cell compartment in children, and such studies have been less detailed than in adults. As a result, much remains to be described with regard to B cells in HIV -infected children.

In this study, I assessed the phenotype and function of B cells in HIV-infected children. I also assessed the in vitro effect of various B-cell stimulant-combinations and the effect of recombinant HIV-1 nef protein on the resultant B-cell responses.

The phenotypic defects observed in the HIV-infected children were broadly similar to those observed in HIV-infected adults but with minor differences. Furthermore, high viraemia and low CD4+ T-cell percentages interfered with the age-related accumulation of B-cell memory, suggesting that children of all ages might benefit from immediate initiation of HAART upon diagnosis with HIV -infection. HIV infection was also associated with poor B-cell responses to vaccine antigens, implying that such children may require revaccination upon initiation of HAART. In the in vitro experiments, different B-cell stimulants elicited synergistic effects on B cells. However, HIV-1 Nef did not affect various B-cell responses upon exposure to the B-cell stimulants.

WHO has recently revised the recommendations for management of paediatric HIV. All children below five years of age are to be started on HAART the moment they are diagnosed with HIV, but such recommendations are yet to be adopted into national guidelines. The possibilities of revaccinating HIV-infected children once on HAART need to be evaluated. Even though some studies have repotted on the possible causes of B cell defects in HIV, more research needs to be done to elucidate other causes that may offer intervention targets.

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