Immunopathogenetic significance of activation and apoptosis of immunocompetent cells in children with HIV infection

The purpose is to clarify the immunopathogenetic significance of immunocompetent cells activation and apoptosis in children with HIV-infection. Materials and methods. A clinical and immunological examination of 92 children aged 1 to 5 years old with HIVinfection in latent stage 3 (25), in the stage of secondary diseases 4A (21), 4B (22) and 4V (24) was conducted. Results. During the clinical examination, the consistent appearance of HIV-associated symptoms, opportunistic infections, and tumors was noted. Changes in the immune status included abnormalities in the T-cell component - a decrease in the number of CD4-, CD3-, increase of CD8-lymphocytes, inversion of the CD4/CD8 ratio, in the B-cell component - hyperimmunoglobulinemia, increase in the content of circulating immune complexes, in the part of innate immunity factors - a decrease in the intensity of the oxygen-dependent neutrophil metabolism and its reserve capabilities. Identified impaired positive activation of lymphocytes - a decrease in the number of CD25- and an increase in HLADR- cells. An increase in the expression of CD95-receptors on the lymphocyte membrane, an increase in the number of lymphocytes in the early (AnV) and late stages of apoptosis (AnV/Pr) was found. With the progression of HIV infection, there was a deepening of these shifts in immunological parameters, especially during the transition to the stage of secondary diseases 4V (AIDS). Conclusion. An immunological examination and correlation analysis showed that an important immunopathogenetic mechanism for reducing the number of CD4 lymphocytes in children with HIV infection is the activation of apoptosis involving the receptor and mitochondrial mechanisms. One of the reasons for the formation of depressed cellular immunity was the hyperactivation of immunocompetent cells. The findings provide a rationale for the timely prescription of antiretroviral therapy for children with HIV-infection, which will prevent hyperactivation and apoptosis of immune system cells.