Effect of Maternal HIV-1 Status and Antiretroviral Drugs on Haematological Profiles of South African Infants in Early Life



Diana B Schramm1, Fiona Anthony1, Busani Mathebula1, Gayle Sherman2, Ashraf Coovadia2, Glenda E Gray3, Louise Kuhn4, Caroline T Tiemessen*, 1
1 AIDS Virus Research Unit, National Institute for Communicable Diseases and Department of Virology, University of the Witwatersrand, Gauteng, South Africa
2 National Health Laboratory Services, Johannesburg, Gauteng, South Africa
3 Perinatal HIV Research Unit, Chris Hani Baragwanath Hospital, Soweto, South Africa
4 Gertrude H. Sergievsky Centre, College of Physicians and Surgeons; and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA


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© Schramm et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the AIDS Virus Research Unit, National Institute for Communicable Diseases, Private Bag X4, Sandringham, 2131, South Africa; Tel: (+27-11) 386-6366/6400; Fax: (+27-11) 386-6465; E-mail: carolinet@nicd.ac.za


Abstract

Maternal HIV-1 status and antiretroviral drug exposure may influence the haematological profiles of infants. We recruited infants from 118 uninfected control women and from 483 HIV-1 infected women who received no antiretroviral drugs (n=28), or received single-dose Nevirapine (sdNVP) (n=424) or triple-drug combination therapy (n=31) to reduce HIV-1 transmission. Blood was drawn from infants within 24 hours of delivery or 6-12 weeks post-delivery and full blood counts performed using a fully automated AcT-5-diff haematology analyser and reference controls. Exposed uninfected (EU; no NVP) differed from control infants only in having lower basophil counts and percentages. In all infant groups, leukocyte profiles showed characteristic quantitative changes with age in the first 6 weeks of life. HIV-1 infected infants displayed by 6 weeks elevations in white blood cells, lymphocyte, monocyte and basophil counts, and monocyte and basophil percentages, when compared to EU infants. At birth EU NVP-treated infants exhibited elevated monocyte percentages and counts and basophil counts that did not persist at 6 weeks. Interestingly, EU newborns of mothers with high CD4 counts (> 500 cells/μl) that had taken sdNVP had significantly elevated white blood cell, monocyte and basophil counts when compared to newborn infants of mothers with similar CD4 counts that had not taken sdNVP; this was not evident in infants of mothers with CD4 counts <200 cells/μl. These previously undescribed features may affect immune response capability in early life and clinical consequences of such changes need to be further investigated.

Keywords: Infant haematological profiles, maternal HIV-1 status, single-dose NVP..