HIV infection compounds the lymphopenia associated with cerebral malaria in Malawian children

Mandala, Wilson L, Gondwe, Esther N, Nyirenda, Tonney S, Draysons, Mark, Molyneux, Malcolm E and MacLennan, Calman A (2019) HIV infection compounds the lymphopenia associated with cerebral malaria in Malawian children. JOURNAL OF BLOOD MEDICINE, 10. pp. 9-18.

Access the full-text of this item by clicking on the Open Access link.

Official URL: http://dx.doi.org/10.2147/jbm.s187081

Abstract

<h4>Aim</h4>Cerebral malaria (CM), unlike severe malarial anemia (SMA), has previously been characterized by pan-lymphopenia that normalizes in convalescence, while HIV infection is associated with depletion of CD4<sup>+</sup> T cells. In this study, we investigate whether HIV infection in Malawian children exacerbates the pan-lymphopenia associated with CM.<h4>Methods</h4>We investigated the absolute and percentage lymphocyte-subset counts and their activation and memory status in Malawian children presenting with either CM who were HIV-uninfected (n=29), HIV-infected (n=9), or SMA who were HIV-uninfected (n=30) and HIV-infected (n=5) in comparison with HIV-uninfected children without malaria (n=42) and HIV-infected children without malaria (n=4).<h4>Results</h4>HIV-infected CM cases had significantly lower absolute counts of T cells (<i>P</i>=0.006), CD4<sup>+</sup> T cells (<i>P</i>=0.0008), and B cells (<i>P</i>=0.0014) than HIV-uninfected CM cases, and significantly lower percentages of CD4<sup>+</sup> T cells than HIV-uninfected CM cases (<i>P</i>=0.005). HIV-infected SMA cases had significantly lower percentages of CD4<sup>+</sup> T cells (<i>P</i>=0.001) and higher CD8<sup>+</sup> T cells (<i>P</i>=0.003) in comparison with HIV-uninfected SMA cases. HIV-infected SMA cases had higher proportions of activated T cells (<i>P</i>=0.003) expressing CD69 than HIV-uninfected SMA cases.<h4>Conclusion</h4>HIV infection compounds the perturbation of acute CM and SMA on lymphocytes, exacerbating subset-specific lymphopenia in CM and increasing activation status in SMA, potentially exacerbating host immunocompromise.

Item Type:	Article
Uncontrolled Keywords:	HIV, cerebral malaria, severe malarial anemia, Malawian children
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User:	Symplectic Admin
Date Deposited:	25 May 2021 10:02
Last Modified:	18 Jan 2023 22:44
DOI:	10.2147/JBM.S187081
Open Access URL:	https://doi.org/10.2147/JBM.S187081
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3123976