在父母联合抗逆转录病毒治疗时代暴露于hiv的未感染婴儿的免疫学。

IF 13 1区 医学 Q1 IMMUNOLOGY
Melanie A Gasper, Anna-Ursula Happel, Sonwabile Dzanibe, Jennifer Slyker, Heather B Jaspan
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引用次数: 0

摘要

妊娠期普遍抗逆转录病毒治疗(备选方案B和备选方案B+)的引入和规划扩大以及随后的普遍检测和治疗方法大大减少了全球婴儿艾滋病毒-1感染,与此同时,暴露于艾滋病毒的未感染婴儿人数也在增加。虽然HEU婴儿的发病率和死亡率历来高于未接触艾滋病毒的婴儿,但有效的父母病毒抑制使艾滋病毒感染者能够更健康地怀孕,并认识到优化喂养做法的好处,这种做法支持通过父母自己的乳汁转移关键营养素和免疫因子。然而,HEU婴儿的残留、炎症加剧、肠道微生物群改变以及先天和适应性免疫的差异仍然存在,并可能导致持续的、较高的感染性发病率。在备选方案B和备选方案B+时代,父母感染艾滋病毒继续影响儿童健康;未来的研究需要揭示这些策略的潜在机制和长期影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Immunology of infants who are HIV-exposed uninfected in the parental combination antiretroviral therapy era.

The introduction and programmatic scale-up of universal antiretroviral therapy in pregnancy (option B and option B+) and the subsequent universal test-and-treat approaches have dramatically reduced infant HIV-1 acquisitions globally, with a parallel increase in the number of infants who are HIV-exposed uninfected (HEU). Although infants who are HEU have historically had higher risk of morbidity and mortality than infants who are HIV unexposed, effective parental viral suppression has enabled people living with HIV to carry healthier pregnancies and realise the benefits of optimised feeding practices that support the transfer of key nutrients and immune factors through their parent's own milk. However, residual, heightened inflammation, altered gut microbiome, and differences in innate and adaptive immunology in infants who are HEU remain, and might contribute to persistent, heightened infectious morbidity. Parental HIV infection continues to influence child health in the option B and option B+ era; future research is needed to uncover underlying mechanisms and long-term implications of these strategies.

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来源期刊
Lancet Hiv
Lancet Hiv IMMUNOLOGYINFECTIOUS DISEASES&-INFECTIOUS DISEASES
CiteScore
19.90
自引率
4.30%
发文量
368
期刊介绍: The Lancet HIV is an internationally trusted source of clinical, public health, and global health knowledge with an Impact Factor of 16.1. It is dedicated to publishing original research, evidence-based reviews, and insightful features that advocate for change in or illuminates HIV clinical practice. The journal aims to provide a holistic view of the pandemic, covering clinical, epidemiological, and operational disciplines. It publishes content on innovative treatments and the biological research behind them, novel methods of service delivery, and new approaches to confronting HIV/AIDS worldwide. The Lancet HIV publishes various types of content including articles, reviews, comments, correspondences, and viewpoints. It also publishes series that aim to shape and drive positive change in clinical practice and health policy in areas of need in HIV. The journal is indexed by several abstracting and indexing services, including Crossref, Embase, Essential Science Indicators, MEDLINE, PubMed, SCIE and Scopus.
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