HUMAN IMMUNODEFICIENCY VIRUS’ EXPOSED UNINFECTED NEWBORNS: A VULNERABLE POPULATION WITH SOME DEFECTIVE IMMUNE SYSTEM ELEMENTS AT BIRTH IN YAOUNDE-CAMEROON, CENTRAL AFRICA

Abstract

Abstract Introduction/Objective The reduction in vertical transmission of human immunodeficiency virus (HIV) in Cameroon, thanks to the success of Option B+ prevention measures, has favored the increase in the rate of HIV exposed uninfected (HEU) infants. The latter, however, present a threefold higher morbidity and mortality than their HIV unexposed and uninfected (HUU) counterparts. With multiple causes, a dysfunction of the immune system would be incriminated but the evidence to demonstrate this and to advocate for a specific follow-up is lacking. This study objective was to determine the effect of in utero exposure to HIV-1 on certain immune elements of HEU newborns. Methods/Case Report A Case-control study was carried out in three reference hospitals in Yaounde. From June 2022 to July 2023, demographical characteristics of 62 HEU newborns of positive parturients with undetectable viral load who gave their consent (cases), and 65 HUU (controls) were taken. Then samples of umbilical cord blood were collected under ethical authorization no. BTC-JIRB2022-021. Then, blood count and differential leukocytes count were performed using DF55 DEMIND and May-Grünwald Giemsa Kit. Excel 2007 and R v4.1.3 softwares were used to record and analyze the data, with significance level for a p-value < 0.05. Results (if a Case Study enter NA) The average APGAR vitality score (appearance, pulse, grimace, activity, respiration) at 1, 5 and 10 min of life was reduced, but not significantly (p = 0.3) in the HEU (8/10, 9/10 and 10/10), compared to the HUU (9/10, and 10/10); as well as head circumference: (33.16 ± 1.64) cm and (34.8 ± 1.52) cm (p = 0.8) respectively. Unlike leukopenia (p=0.24), umbilical monocytosis (p=0.04) and lymphopenia (p=0.001) were significantly linked to HIV exposure in HEU, signs of inflammation from birth. Conclusion HIV exposed uninfected newborns present a drop in immunity and an inflammatory sign at birth, materialised clinically and biologically with a highly significant lymphopenia.