Demographic and medi-laboratorial atopy markers in children with human immunodeficiency virus

Beginning in the 1980s, with the first descriptions of AIDS and the later identification of the human immunodeficiency virus (HIV) as the causal agent, knowledge of immunological alterations that occur in the disease’s evolution has been improving constantly. HIV-infected patients present complex immunological alterations due to CD4+ T lymphocyte depletion and changes in the function of different immune effectors cells, such as polyclonal B cell activation and the consequent increase in immunoglobulin production (Rosenberg & Fauci 1988). These immunological alterations are represented clinically by recurring bacterial infections, opportunistic infections and neoplasias (Luzuriaga & Sullivan 2000, Starr 2003). However, other factors have been identified in the disease’s physiopathology such as an imbalance in cytokine immunoregulation, characterized by a reduction in Type 1 and an increase in Type 2 cytokines (Romagnani & Maggi 1994, Clerici et al. 1997). Different studies have suggested a possible increase in the prevalence of allergic diseases, such as IgE-mediated Type 1 hypersensitivity, in these patients who, paradoxically, have been evolving toward immunosuppression (Lin & Lazarus 1995, Corominas et al. 2000). Recently, this contradictory effect has been attributed to functional and quantitative alterations in regulatory T cells (Kinter et al. 2004, Eggena et al. 2005). These observations suggest that immunological alterations secondary to HIV infection alter the normal allergy control mechanisms, thus permitting an increase in the clinical expression of allergic diseases (Bacot et al. 1997). However, the epidemiology and clinical and laboratory manifestations of atopy have been monitored preferentially in transverse studies in the adult infected population (Sample et al. 1990, Small et al. 1993, Corominas et al. 2000). This study was developed to evaluate prospectively whether immunological alterations and their evolution during the course of HIV infection in children influence the development and prevalence of atopic diseases.