Open Access Short report

Association between lymphocyte and monocyte subsets and cognition in children with HIV

Jintanat Ananworanich11123*, Torsak Bunupuradah1, Tanakorn Apornpong1, Pope Kosalaraksa4, Rawiwan Hansudewechakul5, Suparat Kanjanavanit6, Chaiwat Ngampiyaskul7, Jurai Wongsawat8, Wicharn Luesomboon9, Nicole Ngo-Giang-Huong10, Tanyathip Jaimulwong1, Stephen J Kerr111, Pim Brouwers12, William T Shearer13, Thanyawee Puthanakit114 and on behalf of the PREDICT Study Group

Author Affiliations

1 HIV-NAT, The Thai Red Cross AIDS Research Centre, 104 Rajdumri Road, Pathumwan, Bangkok 10330, Thailand

2 SEARCH, the Thai Red Cross AIDS Research Center, Bangkok, Thailand

3 Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

4 Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand

5 Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand

6 Nakornping Hospital, Chiang Mai, Thailand

7 Prapokklao Hospital, Chantaburi, Thailand

8 Bamrasnaradura Infectious Disease Institute, Nonthaburi, Thailand

9 Queen SavangVadhana Memorial Hospital, Chonburi, Thailand

10 Institut de Recherchepour le Developpement IRD U174, Program for HIV Prevention and Treatment (PHPT), Chiang Mai, Thailand

11 Kirby Institute of Infection and Immunity in Society, The University of New South Wales, Sydney, Australia

12 Division of AIDS Research, National Institute of Mental Health, Bethesda, MD, USA

13 Baylor College of Medicine, Houston, USA

14 Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

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AIDS Research and Therapy 2014, 11:7  doi:10.1186/1742-6405-11-7

Published: 22 January 2014

Abstract

Background

This study assesses the relationships between lymphocyte and monocyte subsets and intelligence quotient (IQ) scores in antiretroviral therapy (ART)-naive, HIV-infected Thai children without advanced HIV disease.

Findings

Sixty-seven ART-naive Thai children with CD4 between 15-24% underwent cognitive testing by Weschler intelligence scale and had 13 cell subsets performed by flow cytometry including naive, memory and activated subsets of CD4+ and CD8+ T cells, activated and perivascular monocytes and B cells. Regression modelling with log10 cell count and cell percentage transformation was performed.

Median age (IQR) was 9 (7–10) years, 33% were male, CDC stages N:A:B were 1:67:31%, median CD4% and count (IQR) were 21 (18–24)%, 597 (424–801) cells/mm3 and HIV RNA (IQR) was 4.6 (4.1-4.9) log10 copies/ml. Most (82%) lived at home, 45% had a biological parent as their primary caregiver, and 26 (49%) had low family income. The mean (SD) scores were 75 (13) for full scale IQ (FIQ), 73 (12) for verbal IQ (VIQ) and 80 (14) for performance IQ (PIQ). Adjusted multivariate regression analysis showed significant negative associations between B cell counts and FIQ, VIQ and PIQ (p < 0.01 for all); similar associations were found for B cell percentages (p < 0.05 for all).

Conclusions

High B cell counts and percentages were strongly associated with poorer FIQ, VIQ and PIQ scores. Prospective, long-term assessment of cell subsets and determination of relevant B cell subpopulations could help further elucidate associations between lymphocyte subsets and neurocognitive development.

Keywords:
Children; HIV; Lymphocytes; Monocytes; Cognition