JAMA: 接触但未感染艾滋病病毒的婴儿抵抗力较差

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8日公布的一项研究成果显示，与从未接触过艾滋病病毒环境的婴儿相比，那些曾接触过母体艾滋病病毒环境但自身未感染的婴儿的抵抗力较差。这项研究成果9日将发表在《美国医学会杂志》上。
英国帝国理工学院的研究人员分析了母体艾滋病病毒感染与母亲及婴儿体内特异性抗体水平之间的关系。这项研究于2009年3月至2010年4月在南非西开普省开展，研究对象包括109名已感染及未感染艾滋病病毒的妇女及其子女。在新生儿16周时，研究人员提取他们的血清样品，测试其特异性抗体水平。
研究人员发现，与未接触过艾滋病病毒的婴儿相比，曾接触但未感染艾滋病病毒的婴儿体内针对Ｂ型流感嗜血杆菌、百日咳杆菌、肺炎球菌和破伤风杆菌的特异性抗体的水平较低。
研究人员表示，接触过艾滋病病毒但并未感染的婴儿代表了一个脆弱群体，他们下呼吸道感染和脑膜炎的发病率会增加，第一年的死亡率是普通婴儿的数倍。这项研究成果可以解释为何这部分婴儿拥有较高的发病率和死亡率。

JAMA. 2011;305(6):576-584. doi: 10.1001/jama.2011.100(杂志影响因子28.9, 2009年)
Maternal HIV Infection and Antibody Responses Against Vaccine-Preventable Diseases in Uninfected InfantsChristine E. Jones, BMBS, MRCPCH; Shalena Naidoo, BSc; Corena De Beer, PhD; Monika Esser, MBChB, MMed (Paed); Beate Kampmann, MBBS, PhD; Anneke C. Hesseling, MD, PhD
AbstractContext Altered immune responses might contribute to the high morbidity and mortality observed in human immunodeficiency virus (HIV)?exposed uninfected infants.
Objective To study the association of maternal HIV infection with maternal- and infant-specific antibody levels to Haemophilus influenzae type b (Hib), pneumococcus, Bordetella pertussis antigens, tetanus toxoid, and hepatitis B surface antigen.
Design, Setting, and Participants A community-based cohort study in Khayelitsha, Western Cape Province, South Africa, between March 3, 2009, and April 28, 2010, of 109 HIV-infected and uninfected women and their infants. Serum samples from 104 women and 100 infants were collected at birth and samples from 93 infants were collected at 16 weeks.
Main Outcome Measure Level of specific antibody in mother-infant pairs at delivery and in infants at 16 weeks, determined by enzyme-linked immunosorbent assays.
Results At birth, HIV-exposed uninfected infants (n = 46) had lower levels of specific antibodies than unexposed infants (n = 54) did to Hib (0.37 [interquartile range {IQR}, 0.22-0.67] mg/L vs 1.02 [IQR, 0.34-3.79] mg/L; P < .001), pertussis (16.07 [IQR, 8.87-30.43] Food and Drug Administration [FDA] U/mL vs 36.11 [IQR, 20.41-76.28] FDA U/mL; P < .001), pneumococcus (17.24 [IQR, 11.33-40.25] mg/L vs 31.97 [IQR, 18.58-61.80] mg/L; P = .02), and tetanus (0.08 [IQR, 0.03-0.39] IU/mL vs 0.24 [IQR, 0.08-0.92] IU/mL; P = .006). Compared with HIV-uninfected women (n = 58), HIV-infected women (n = 46) had lower specific antibody levels to Hib (0.67 [IQR, 0.16-1.54] mg/L vs 1.34 [IQR, 0.15-4.82] mg/L; P = .009) and pneumococcus (33.47 [IQR, 4.03-69.43] mg/L vs 50.84 [IQR, 7.40-118.00] mg/L; P = .03); however, no differences were observed for antipertussis or antitetanus antibodies. HIV-exposed uninfected infants (n = 38) compared with HIV-unexposed infants (n = 55) had robust antibody responses following vaccination, with higher antibody responses to pertussis (270.1 [IQR, 84.4-355.0] FDA U/mL vs 91.7 [IQR, 27.9-168.4] FDA U/mL; P = .006) and pneumoccocus (47.32 [IQR, 32.56-77.80] mg/L vs 14.77 [IQR, 11.06-41.08] mg/L; P = .001).

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接触过艾滋病病毒但并未感染的婴儿代表了一个脆弱群体，他们下呼吸道感染和脑膜炎的发病率会增加，第一年的死亡率是普通婴儿的数倍。这项研究成果可以解释为何这部分婴儿拥有较高的发病率和死亡率。”
学习了，对今后的工作有启发，谢谢！