Objective: Several co-infections have been shown to impact the progression of HIV-1 infection. We sought determine if treatment helminth co-infection in HIV-1-infected adults impacted markers disease progression. Design: To date, there no randomized trials examine effects soil-transmitted eradication on Methods: A randomized, double-blind, placebo-controlled trial albendazole (400 mg daily for 3 days) antiretroviral-naive (CD4 cell count >200 cells/μl) with infection was conducted at 10...

Objective: Cytomegalovirus (CMV) coinfection may influence HIV-1 disease progression during infancy. Our aim was to describe the incidence of CMV infection and kinetics viral replication in Kenyan HIV-infected HIV-exposed uninfected infants. Methods: plasma loads were serially measured 20 44 infants born mothers. children studied for first 2 years life, 1 year. Results: DNA detected frequently months life; by 3 age, 90% 93% who had acquired utero. highest 1–3 following detection virus...

Mother-child human leukocyte antigen (HLA) concordance and maternal HLA homozygosity may increase the risk of vertical transmission immunodeficiency virus type 1 (HIV-1) by reducing infant immune responses.We analyzed mother-child in a Kenyan perinatal cohort receiving antenatal zidovudine. was scored as number shared class I alleles, relative estimates were adjusted for HIV-1 load.Among 277 mother-infant pairs, occurred 58 infants (21%), with utero 21 (36%), peripartum 26 (45%), via...

In Brief OBJECTIVE: To determine whether herpes simplex virus type 2 (HSV-2) infection was associated with risk of intrapartum human immunodeficiency 1 (HIV-1) transmission and to define correlates HSV-2 among HIV-1-seropositive pregnant women. METHODS: We performed a nested case control study within perinatal cohort in Nairobi, Kenya. Herpes serostatus the presence genital ulcers were ascertained at 32 weeks gestation. Maternal cervical plasma HIV-1 RNA HSV DNA measured delivery. RESULTS:...

Natural killer (NK) cells play an important role in the containment of HIV replication during primary infection, though their functions are impaired chronic infection. Infants experience more rapid disease progression than adults, but contributions infant NK to containing infection unknown. The aim this study was determine impact on cell phenotype by evaluating samples and data from a cohort women infants, conducted Nairobi, Kenya between 1999-2003. percentage evaluated longitudinally...

Objective: Cytomegalovirus (CMV) is an important pathogen in healthy neonates and individuals with human immunodeficiency virus (HIV-1). The objective of this study was to determine whether the detection CMV DNA (CMV DNAemia) maternal plasma associated mortality HIV-1-infected women or their infants. Methods: A longitudinal designed examine relationship between DNAemia maternal-infant during 2 years postpartum. Sixty-four infants were studied. loads quantified from mothers near time...

Background: HIV-1-infected children have lower response rates after measles and tetanus immunization than uninfected children. We determined the extent to which highly active antiretroviral therapy (HAART) augments vaccine immunity promotes responses revaccination. Methods: Previously immunized, antiretroviral-naive were evaluated for against tetanus. After 6 months on HAART, meeting CD4% criteria (>15%) who persistently antibody negative revaccinated was reassessed. Results: At enrollment,...

Objective: Cervicovaginal HIV-1-neutralizing immunoglobulin A (IgA) was associated with reduced HIV-1 acquisition in a cohort of commercial sex workers. We aimed to define the prevalence and correlates IgA from HIV-1-exposed seronegative (HESN) women HIV-1-serodiscordant relationships. Methods: couples Nairobi were enrolled followed quarterly up 2 years, concordant HIV-1-negative relationships as controls. Cervicovaginal, seminal, blood samples collected at enrollment follow-up. assessed for...

Abstract Maternal human immunodeficiency virus (HIV) infection has been shown to leave profound and lasting impacts on the HIV-exposed uninfected (HEU) infant, including increased mortality morbidity, immunological changes, developmental delays compared their HIV-unexposed (HU) counterparts. Exposure HIV or antiretroviral therapy may influence immune development, which could increase morbidity mortality. However, a direct link between infant’s system not identified. To provide global picture...

ABSTRACT Cytomegalovirus (CMV) coinfection is associated with infant HIV-1 disease progression and mortality. In a cohort of Kenyan HIV-infected infants, the frequencies activated (CD38 + HLA-DR ) apoptosis-vulnerable (CD95 Bcl-2 − CD4 CD8 T cells increased substantially during acute CMV infection. The frequency was strongly both concurrent ( P = 0.001) viral load 0.05). also in 0.02) < cell subsets. Similar observations were made HIV-exposed uninfected infants. CMV-induced increases...

Objective: The effects of sex hormones on the immune defenses female genital mucosa and its susceptibility to infections are poorly understood. injectable hormonal contraceptive depot medroxyprogesterone acetate (DMPA) may increase risk for HIV-1 acquisition. We assessed local concentration in cationic polypeptides with reported antiviral activity relation DMPA use. Methods: HIV-1–uninfected women were recruited from among couples testing HIV Nairobi, Kenya. Cervicovaginal secretion samples...

Breast milk is a major route of infant HIV infection, yet the majority breast-fed, HIV-exposed infants escape infection by unknown mechanisms. This study aimed to investigate role HIV-specific breast cells in preventing infection.A prospective was designed measure associations between maternal interferon-γ (IFN-γ) responses and HIV-1 detection at 1 month age.In Kenyan cohort HIV-infected mothers, blood HIV-gag IFN-γ ELISpot were measured. Logistic regression used age.IFN-γ detected from 117...

Infants born to HIV-1 infected mothers may have increased risk for tuberculosis (TB), but the prevalence of TB infection in this population is undefined. In contrast tuberculin skin tests that are confounded by recent bacille Calmette-Guérin (BCG) vaccination, interferon gamma release assays (IGRAs) do not cross-react with BCG and enable detection infancy.In a nested observational cohort Kenyan their infants, we conducted T-SPOT.TB on cryopreserved peripheral blood mononuclear cells from...

Abstract Background In low and middle income countries, human immunodeficiency virus (HIV) exposed, uninfected (HEU) infants demonstrate higher morbidity mortality than their unexposed counterparts. To determine possible immune correlates of this effect, we investigated the impact in utero HIV exposure on neonatal milieu maternal factors mediating these abnormalities a cohort vaginally delivered mother‐infants. Samples delivery cord blood plasma were selected from 22 Kenyan HIV‐infected...

Breastmilk chemokines have been associated with increased HIV-1 RNA levels in breastmilk and altered risk of mother-to-child transmission. To characterize CC CXC postpartum, we collected specimens at regular intervals for 6 months after delivery from women without infection used commercial ELISA kits to measure concentrations MIP-1α, MIP-1β, RANTES, SDF-1α. Among 54 HIV-1-infected 26 uninfected women, mean chemokine were compared cross-sectionally longitudinally days 5 10, 1 3 postpartum....

Although CD8(+) T cells play an important role in the containment of adult HIV-1 replication, their infant infection is not as well understood. Impaired HIV-specific cell responses may underlie persistently high viral loads observed infants. We examined frequency and phenotype 7 HIV-infected antiretroviral therapy-naïve infants during first 2 years life, using class I HLA tetramers IFN-γ-ELISPOT. The (0.088-3.9% CD3(+)CD8(+) cells) (CD27(+)CD28(-), CD45RA(+/-), CD57(+/-), HLA-DR(+), CD95(+))...

Exclusive breastfeeding (EBF) is recommended for 6 months after delivery as the optimal infant feeding method and especially important prevention of mother-to-child HIV transmission (PMTCT). However, EBF promotion efforts among HIV-infected mothers in sub-Saharan Africa have achieved mixed success require context-specific interventions. HIV-positive, pregnant women from six clinics Nairobi were enrolled into a clinic-level, before-after counseling intervention study. All received standard...

Summary Humoral immunity, and specifically immunoglobulin A (IgA) that is directed against human immunodeficiency virus (HIV)-1, may contribute to protection HIV-1 acquisition at mucosal surfaces. HIV-1-specific IgA has been detected in genital tract secretions of HIV-1-uninfected commercial sex workers with exposure, be produced parotid saliva by infants exposed orally during delivery breastfeeding. To explore this hypothesis, we collected from 145 aged ≤ 6 months enrolled a perinatal...

Summary The C868T single nucleotide polymorphism (SNP) in the CD4 receptor encodes an amino acid change that could alter its structure and influence human immunodeficiency virus (HIV-1) infection risk. HIV-1-infected pregnant women Nairobi were followed with their infants for 1 year postpartum. Among 131 infants, those 868T allele more likely than wild-type to acquire HIV-1 overall [hazard ratio (HR) = 1.92, 95% confidence interval (CI) 1.05, 3.50, P 0.03; adjusted HR 2.03, CI 1.03, 3.98,...

A safe, effective vaccine for breastfeeding infants born to HIV-1-positive mothers could complement antiretroviral therapy (ART) prevention of mother-to-child transmission HIV-1. To date, only a few HIV-1 candidates have been tested in infants. phase I/II randomized controlled trial PedVacc 002 was conducted determine the safety and immunogenicity single, low dose MVA.HIVA delivered intramuscularly healthy 20-week-old Nairobi, Kenya. Pregnant women 2nd/3rd trimester gestation were enrolled,...

Background: HIV-1 infection may impair transplacental antibody transfer to infants. The impact of highly active antiretroviral treatment (ART) given during pregnancy on transport is unknown. Methods: infected pregnant women with CD4 counts between 200 – 500 were randomized short-course zidovudine (ZDV) or triple ART at 32 weeks gestation for prevention mother-to-child transmission. Levels maternal against measles, pneumococcus and rotavirus delivery, the baby through cord blood, compared...

We examined associations between maternal human leukocyte antigen (HLA) and vertical immunodeficiency virus type 1 (HIV-1) transmission in a perinatal cohort of 277 HIV-infected women Nairobi. HLA class I genes were amplified by using sequence-specific oligonucleotide probes, analyses performed logistic regression. Maternal HLA-A*2301 was associated with increased risk before after adjusting for viral load (unadjusted: odds ratio [OR], 3.21; 95% confidence interval [CI], 1.42−7.27; P = .005;...

Background. The synergy between herpes simplex virus type 2 (HSV-2) and human immunodeficiency 1 (HIV-1) is well known, but lack of knowledge about the epidemiology HSV-2 acquisition in HIV-1-discordant couples hampers development prevention interventions that could reduce HIV-1 transmission. Methods. were enrolled Nairobi, Kenya, followed for up to years. status was determined using HerpeSelect ELISA. Correlates prevalence incidence assessed. Results. Of 469 couples, at baseline, 353...

This article describes results from a cross-sectional study among HIV-infected children 15 months to 12 years of age who were receiving antiretroviral therapy. We found low prevalence measles IgG seropositivity (45.7%) and identified CD4% ≥ 25 as predictor. Most on ART not seropositive might benefit revaccination.