Finally, we aimed to examine a possible correlation between ultrasound-obtained thymic size, T-lymphocyte subsets in peripheral blood, and the frequency of infections.įrom December 1996 to October 1999, all infants born to HIV-positive mothers at Hvidovre University Hospital were invited to participate in the study. Furthermore, the impact of prenatal HIV exposure on HIV-negative infants fed with human donor milk in their first four months of life on the thymic size and frequency of infections during the first year of life was evaluated. The present study was conducted to evaluate the thymic size in HIV-EU infants compared to term HIV-unexposed infants. However, lower CD4 counts in thymectomized children did not seem to lead to more infections in childhood. In a clinical review of the best available evidence, 9 case-control studies of neonatal thymectomy in cardiac surgery were reviewed neonatal thymectomy had a documented effect on T-cell numbers and distribution, and the CD4 count decreased after thymectomy in all the studies reviewed. In a previous study of healthy mature infants followed up to 10 months of age, we demonstrated a correlation between thymic size and CD8+ cells.

In the two African studies of HIV-infected children, the thymic volume was found to correlate positively with the CD4 count and negatively with HIV viral load. Therefore, the thymic size in early infancy might correlate to later immune function.įew studies have managed to demonstrate an association between thymic size and T-lymphocytes. Furthermore, in a study from Guinea-Bissau, a small thymic size at 6 months of age was a strong risk factor for mortality.

In HIV-infected children, thymic size is smaller compared to HIV-negative children, as reported in two African studies. Furthermore, feeding HIV-exposed uninfected (HIV-EU) infants with donor breast milk up to 4 months of age leads to a thymic size less than in breastfed infants, but larger than in exclusively formula-fed infants at the same age. We have also demonstrated that breastfed infants born at term have a larger thymus than term, formula-fed infants. The positive correlation between thymic size and weight and length at birth and during the first months of life is well known and infections are reported to result in decreasing thymic size. The transition of T-cell progenitors in the thymus has been extensively evaluated, but the significance of the size or alterations in the size of the thymus in infancy is still unclear. The thymus is also known to be a target organ in HIV-infection. The thymus plays a key role in the development of a functional immune system, providing the environment for T-lymphocyte maturation and being a central organ for the development and maintenance of cell-mediated immunity. However, reports on the long-term impact of HIV exposure on the immune system have been conflicting and there have been very few studies of whether the infection burden in HIV-EU infants is higher than in HIV-unexposed infants.

Despite HIV-EU infants remaining uninfected, there have been reports of impaired immune function and reduced CD4 counts in HIV-EU newborns. Consequently, the number of HIV-exposed uninfected (HIV-EU) infants in the world is growing. Vertical transmission of HIV from HIV-positive mothers to their infants is, in industrialised countries, reduced to less than 1-2%. We suggest, when breastfeeding is not possible, that providing human donor milk to vulnerable groups of infants will be beneficial for their maturing immune system. This finding along with fewer infections in exclusively breastfed infants compared to formula-fed infants supports the beneficial effect of human milk on the immune system. HIV-EU infants fed human donor milk have normal growth of thymus and contract fewer infections than other healthy infants. Furthermore, in the control group, the infants exclusively breastfed at 4 months of age had significantly fewer infections at 8 months when compared to age-matched formula-fed infants ( P = 0.001). At 4 months of age, the HIV-EU infants had significantly fewer infections than the control infants ( P < 0.001). The thymic size at 12 months of age was not significantly different between the HIV-EU group and the control infants ( P = 0.56). The infants were compared to a cohort of 47 term, HIV-unexposed breastfed or formula-fed infants. Ultrasound-obtained thymic index (Ti), T-lymphocyte subsets, and the number of infections were examined from birth to 18 months of age in 18 HIV-EU infants. To evaluate the immune function in HIV-exposed uninfected (HIV-EU) infants fed human donor milk.

Dj mixmax 2013