Immune Activation and Microbial Translocation Markers in HIV-Exposed Uninfected Malawian Infants in the First Year of Life

Silvia Baroncelli, Clementina Maria Galluzzo, Giuseppe Liotta, Mauro Andreotti, Sandro Mancinelli, Robert Mphwere, Enok Bokola, Roberta Amici, Maria Cristina Marazzi, Leonardo Palombi, Lucia Palmisano, Marina Giuliano

Research output: Contribution to journalArticlepeer-review


BACKGROUND: HIV-exposed uninfected (HEU) infants show a high rate of morbidity. We aimed to investigate on biomarkers of immune activation/microbial translocation in HEU infants, evaluating the impact that infections/malnutrition can have on biomarker levels during the first year of life.

METHODS: Clinical data of 72 Malawian infants were recorded monthly and correlated with levels of soluble CD14 (sCD14), lipopolysaccharide-binding protein (LBP) and intestinal fatty acid-binding protein (I-FABP), analyzed longitudinally.

RESULTS: Levels of sCD14 and LBP showed a significant age-related increase. Higher levels of LBP (19.4 vs. 15.2 μg/ml) were associated with stunting, affecting 30% of the infants. The association remained statistically significant after adjusting for cytomegalovirus acquisition, malaria and respiratory infections (p = 0.031). I-FABP levels were significantly increased in infants experiencing gastrointestinal infections (1442.8 vs. 860.0 pg/ml, p = 0.018).

CONCLUSION: We provide evidence that stunting is associated with an enhanced inflammatory response to microbial products in HEU children, suggesting that malnutrition status should be taken into consideration to better understand the alteration of the immune profile of HEU infants living in poor socioeconomic settings.

Original languageEnglish
Pages (from-to)617-625
Number of pages9
JournalJournal of Tropical Pediatrics
Issue number6
Publication statusPublished - Dec 1 2019


  • Acute-Phase Proteins
  • Anti-Retroviral Agents/therapeutic use
  • Bacterial Translocation
  • Biomarkers/blood
  • Carrier Proteins/blood
  • Fatty Acid-Binding Proteins/blood
  • Female
  • Gastrointestinal Diseases
  • Growth Disorders/blood
  • HIV Infections/drug therapy
  • Humans
  • Infant
  • Infant Nutrition Disorders/blood
  • Lipopolysaccharide Receptors/blood
  • Malawi
  • Male
  • Membrane Glycoproteins/blood
  • Pregnancy
  • Pregnancy Complications, Infectious/drug therapy


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