Imperial College London
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DrFelicityFitzgerald

Faculty of Medicine, Department of Infectious Disease

Senior Clinical Research Fellow
 
 
 
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f.fitzgerald

 
 
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Location

 

Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Fitzgerald:2019:infdis/jiy495,
author = {Fitzgerald, FC and Lhomme, E and Harris, K and Kenny, J and Doyle, R and Kityo, C and Shaw, LP and Abongomera, G and Musiime, V and Cook, A and Brown, JR and Brooks, A and Owen-Powell, E and Gibb, DM and Prendergast, AJ and Sarah, Walker A and Thiebaut, R and Klein, N and CHAPAS-3, Trial Team},
doi = {infdis/jiy495},
journal = {Journal of Infectious Diseases},
pages = {89--100},
title = {Microbial translocation does not drive immune activation in Ugandan children infected with HIV},
url = {http://dx.doi.org/10.1093/infdis/jiy495},
volume = {219},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objective: Immune activation is associated with morbidity and mortality during human immunodeficiency virus (HIV) infection, despite receipt of antiretroviral therapy (ART). We investigated whether microbial translocation drives immune activation in HIV-infected Ugandan children. Methods: Nineteen markers of immune activation and inflammation were measured over 96 weeks in HIV-infected Ugandan children in the CHAPAS-3 Trial and HIV-uninfected age-matched controls. Microbial translocation was assessed using molecular techniques, including next-generation sequencing. Results: Of 249 children included, 142 were infected with HIV; of these, 120 were ART naive, with a median age of 2.8 years (interquartile range [IQR], 1.7-4.0 years) and a median baseline CD4+ T-cell percentage of 20% (IQR, 14%-24%), and 22 were ART experienced, with a median age of 6.5 years (IQR, 5.9-9.2 years) and a median baseline CD4+ T-cell percentage of 35% (IQR, 31%-39%). The control group comprised 107 children without HIV infection. The median increase in the CD4+ T-cell percentage was 17 percentage points (IQR, 12-22 percentage points) at week 96 among ART-naive children, and the viral load was <100 copies/mL in 76% of ART-naive children and 91% of ART-experienced children. Immune activation decreased with ART use. Children could be divided on the basis of immune activation markers into the following 3 clusters: in cluster 1, the majority of children were HIV uninfected; cluster 2 comprised a mix of HIV-uninfected children and HIV-infected ART-naive or ART-experienced children; and in cluster 3, the majority were ART naive. Immune activation was low in cluster 1, decreased in cluster 3, and persisted in cluster 2. Blood microbial DNA levels were negative or very low across groups, with no difference between clusters except for Enterobacteriaceae organisms (the level was higher in cluster 1; P < .0001). Conclusion: Immune activation decreased with ART use, with marker clustering indicatin
AU  - Fitzgerald,FC
AU  - Lhomme,E
AU  - Harris,K
AU  - Kenny,J
AU  - Doyle,R
AU  - Kityo,C
AU  - Shaw,LP
AU  - Abongomera,G
AU  - Musiime,V
AU  - Cook,A
AU  - Brown,JR
AU  - Brooks,A
AU  - Owen-Powell,E
AU  - Gibb,DM
AU  - Prendergast,AJ
AU  - Sarah,Walker A
AU  - Thiebaut,R
AU  - Klein,N
AU  - CHAPAS-3,Trial Team
DO  - infdis/jiy495
EP  - 100
PY  - 2019///
SN  - 0022-1899
SP  - 89
TI  - Microbial translocation does not drive immune activation in Ugandan children infected with HIV
T2  - Journal of Infectious Diseases
UR  - http://dx.doi.org/10.1093/infdis/jiy495
UR  - https://www.ncbi.nlm.nih.gov/pubmed/30107546
UR  - http://hdl.handle.net/10044/1/100031
VL  - 219
ER  -
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