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首页> 美国卫生研究院文献>Frontiers in Immunology >Increased Risk of Group B Streptococcus Invasive Infection in HIV-Exposed but Uninfected Infants: A Review of the Evidence and Possible Mechanisms
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Increased Risk of Group B Streptococcus Invasive Infection in HIV-Exposed but Uninfected Infants: A Review of the Evidence and Possible Mechanisms

机译：HIV暴露但未感染婴儿的B组链球菌侵袭感染风险增加：证据和可能机制的综述

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摘要

Group B Streptococcus (GBS) is a major cause of neonatal sepsis and mortality worldwide. Studies from both developed and developing countries have shown that HIV-exposed but uninfected (HEU) infants are at increased risk of infectious morbidity, as compared to HIV-unexposed uninfected infants (HUU). A higher susceptibility to GBS infections has been reported in HEU infants, particularly late-onset diseases and more severe manifestations of GBS diseases. We review here the possible explanations for increased susceptibility to GBS infection. Maternal GBS colonization during pregnancy is a major risk factor for early-onset GBS invasive disease, but colonization rates are not higher in HIV-infected compared to HIV-uninfected pregnant women, while selective colonization with more virulent strains in HIV-infected women is suggested in some studies. Lower serotype-specific GBS maternal antibody transfer and quantitative and qualitative defects of innate immune responses in HEU infants may play a role in the increased risk of GBS invasive disease. The impact of maternal antiretroviral treatment and its consequences on immune activation in HEU newborns are important to study. Maternal immunization presents a promising intervention to reduce GBS burden in the growing HEU population.
机译：B组链球菌（GBS）是全世界新生儿败血症和死亡率的主要原因。来自发达国家和发展中国家的研究均表明，与未接触艾滋病毒的未感染婴儿（HUU）相比，接触过艾滋病毒但未感染（HEU）的婴儿患病的风险更高。在HEU婴儿中，对GBS感染的敏感性更高，特别是晚发疾病和更严重的GBS疾病表现。我们在这里复查对GBS感染易感性增加的可能解释。孕妇在怀孕期间的GBS菌落定植是发生早期GBS侵袭性疾病的主要危险因素，但是与未感染HIV的孕妇相比，HIV感染的菌落定植率不高，但建议在HIV感染的妇女中选择强毒株进行选择性定植在一些研究中。 HEU婴儿中较低的血清型特异性GBS母源抗体转移以及先天性免疫反应的定量和定性缺陷可能在增加GBS浸润性疾病的风险中起作用。母体抗逆转录病毒治疗的影响及其对HEU新生儿免疫激活的影响对于研究至关重要。孕产妇免疫是一种有希望的干预措施，可以减少不断增长的HEU人群的GBS负担。

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