Population Lymphocytaire des Nourrissons Exposés mais non Infectés par le VIH à Douala

Noel Emmanuel Essomba, D Adiogo, GP Ngaba, L Djamilatou, LG Lehman, Y Coppieters

Abstract


RÉSUMÉ
Introduction. L’objectif de cette étude était de mettre rechercher la présence d’un déficit en cellules T chez le nourrisson exposé non infectés (ENI), l’hypothèse étant que le déficit serait plus marqué lorsque la charge virale maternelle est élevée. Matériels et méthodes. Il s’agit d’une étude transversale analytique menée du 1er décembre 2015 au 08 juin 2016. En phase rétrospective, les données ont été collectées à base d’un questionnaire préétabli. En phase prospective les prélèvements sanguins ont été effectués et les profils immunologiques ont été établis. Les facteurs de transmission du VIH de la mère à l'enfant ont été évalués par régression logistique multi variée. Le test de Hosmer et Lemeshow ont été utilisés pour vérifier l'ajustement du modèle. Résultats. 153 patients répartis en trois groupes dont 60 enfants exposés non infectés, 60 enfants non exposés (NE) et 33 enfants exposés infectés (EI) ont été enrôlés. Les profils immunologiques des enfants NE et ENI ont montré une différence statistiquement significative (P=0,007) pour les taux de CD4. Les profils immunologiques des enfants de la tranche d’âge de 12 à 59 mois d’une part EI et ENI ont montré des différences significatives pour les CD45 (P=0,003), les CD4 (P=0,01), les CD8 (P=0,02). Conclusion. Chez les nourrissons non infectés nés de mères séropositives, plusieurs anomalies immunologiques peuvent être détectées. Ces anomalies pourraient être une conséquence de l’exposition au VIH in utero et en début de vie, et/ou à l’exposition aux médicaments antirétroviraux, ou à la transmission précoce des infections virales persistantes telles que CMV.

ABSTRACT
Introduction. The objective of the study was to assess the presence of age-dependent T-cell deficiency in the exposed uninfected infant (EUI) and to test the hypothesis that it should be more marked when the maternal viral load is high. Materials and methods. This was a cross-sectional analytical study carried out from 1st December 2015 to 08 June 2016. In retrospect, the data were collected on the basis of a pre-established questionnaire. In the prospective phase the blood samples were taken and the immunological profiles were established. The factors relating to mother-to-child transmission of HIV were assessed by multi-varied logistic regression. The Hosmer and Lemeshow test were used to check the fit of the model. Results. A total of 153 patients were enrolled in three groups, including 60 ENI children, 60 unexposed children (NE) and 33 exposed infected children (EI). Immunological profiles of NE and ENI children showed a statistically significant difference (P = 0.007) for CD4 levels. Immunological profiles of children in the 12 to 59 month age group on the one hand EI and ENI showed significant differences for CD45 (P = 0.003), CD4 (P = 0.01), CD8 (P = 0.02). Conclusion. Several immunological abnormalities can be detected in the blood of uninfected infants born to seropositive mothers; These abnormalities could be a consequence of exposure to HIV in utero and early life, and / or exposure to antiretroviral drugs, as well as the early transmission of persistent viral infections such as CMV.


Keywords


phénotype immunologique, immunodépression, exposés non infectés, exposés infectés.

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