NATURAL-KILLER ACTIVITY, TUMOR-NECROSIS-FACTOR-ALPHA, AND INTERFERON-GAMMA PRODUCTION IN HIV-INFECTED CHILDREN AT VARIOUS STAGES OF DISEASE

We have compared the levels of natural killer (NK) activity and of tum or necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma) production in human immunodeficiency virus (HIV)-infected children (HI V+) with those of HIV-negative (HIV-) children born to HIV+ mothers. N K activity was significantly lower in HIV+ children than in HIV- contr ols (p < 0.05), except for the group with the lowest CD4(+) count and with opportunistic infections. Cells with NK phenotype were also fewer in the HIV+ group, although there was an increase in activated T lymp hocytes DR(+) CD3(+) (p < 0.05), related to increased CD8(+) CD57(+) c ells. TNF-alpha and IFN-gamma production was greater in HIV+ patients than in controls (p = 0.052; p < 0.05). This difference was due to pat ients with lymphocytic interstitial pneumonitis (LIP), who had signifi cantly higher levels of TNF-alpha and IFN-gamma than the other HIV+ ch ildren (p < 0.002; p < 0.003) or the control group (p < 0.001). Neithe r p24 antigenemia nor decreased numbers of CD4(+) cells were associate d with increased levels of these cytokines.