We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
A Tale of 2 Pneumos: The Impact of Human Immunodeficiency Virus Exposure or Infection Status on Pediatric Nasopharyngeal Carriage of Streptococcus pneumoniae and Pneumocystis jiroveci: A Nested Case Control Analysis From the Pneumonia Etiology Research In Child Health Study
- Authors
Camelo, Ingrid Y; Mwananyanda, Lawrence M; Thea, Donald M; Seidenberg, Philip; Gill, Christopher J; Weinstein, John R
- Abstract
Background The majority of pediatric human immunodeficiency virus (HIV) cases in Africa reflect maternal-to-child transmission. HIV exposed but uninfected (HEU) children have increased rates of morbidity and mortality when compared to HIV unexposed and uninfected (HUU) children. The mechanisms behind these unexpected trends are only partially understood but could be explained by the differences in the immune response to infections triggered by an altered immune system state. Methods Using quantitative reverse transcription polymerase chain reaction, we compared the nasopharyngeal carriage prevalence and density of Streptococcus pneumoniae (SP) and Pneumocystis jirovecii (PJ) between children living with HIV and HEU or HUU cases (pneumonia) and controls (without pneumonia). Results The cohort included 1154 children (555 cases and 599 matched controls). The SP carriage prevalence rates were similar between cases and controls. Among SP carriers with pneumonia, carriage density was increased among children living with HIV, versus HEU or HUU children (15.8, 4.7, and 3.6 × 105 copies/mL, respectively). The rate of PJ carriage was significantly higher among children living with HIV than among HEU and HUU children (31%, 15%, and 10%, respectively; P < .05), as was carriage density (63.9, 20.9, and 4.8 × 103 copies/mL, respectively; P < .05). Conclusions Carriage prevalences and densities for SP and PJ show different kinetics in terms of their relationship with HIV exposure and clinical status, particularly for Pneumocystis jirovecii. This supports the theory that the increased morbidity and mortality observed among HEU children may reflect deficits not just in humoral immunity but in cell-mediated immunity as well.
- Subjects
NASOPHARYNX microbiology; HIV infections; REVERSE transcriptase polymerase chain reaction; PNEUMOCYSTIS pneumonia; STREPTOCOCCAL diseases; CASE-control method; QUANTITATIVE research; DISEASES; STREPTOCOCCUS; PRENATAL exposure delayed effects; DISEASE prevalence; DESCRIPTIVE statistics; CARRIER state (Communicable diseases); POLYMERASE chain reaction; HIV; VERTICAL transmission (Communicable diseases)
- Publication
Clinical Infectious Diseases, 2021, Vol 72, Issue 6, p1033
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciaa164