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Family Adversity and Autonomic Reactivity Association With Immune Changes in HIV-Affected School Children

Thomas, Melanie R. MS, MD; Wara, Diane MD; Saxton, Katherine MPH, PhD; Truskier, Mary RN, MS, PNP; Chesney, Margaret A. PhD; Boyce, W. Thomas MD

doi: 10.1097/PSY.0b013e31829807fb
Original Articles

Objective To explore whether primary school entry is associated with changes in immune system parameters in HIV-affected children. HIV-affected children are vulnerable to psychosocial stressors, regardless of their own HIV serological status.

Methods Data from 38 HIV-positive and 29 HIV-negative children born to seropositive women were obtained. Measures included family adversity questionnaires, autonomic nervous system (ANS) reactivity, and enumerative and functional changes in peripheral blood immune parameters.

Results In comparison with children who were HIV-negative, children who were HIV-positive at baseline had fewer CD4+ T lymphocytes (mean [M] = 916 versus 1206 cells/mm3 × 103; F = 7.8, p = .007), more CD8+ cells (M = 1046 versus 720 cells/mm3 × 103; F = 7.98, p = .006), and diminished natural killer cell cytotoxicity (M = −0.29 versus 0.41; F = 8.87, p = .004). School entry was associated with changes in immune parameters, but HIV status was not associated with the magnitude of changes. Changes in immune parameters after school entry were associated with family stress and preschool entry ANS reactivity. Highly ANS reactive children had either the greatest increase in CD8+ cells after school entry or the greatest decrease, depending on reported levels of family adversity (B = 215.35; t = 3.74, p < .001). Changes in functional immune assays were significantly associated with the interactions between HIV status and ANS reactivity.

Conclusions These results suggest that autonomic reactivity is associated with increased immunological sensitivity to adverse or challenging social contexts among children affected by HIV.

From the University of California, San Francisco (M.R.T., D.W., M.C.), San Francisco, California; University of California, Berkeley (K.S.), Oakland, California; and The University of British Columbia (W.T.B.), Vancouver, British Columbia.

Address correspondence and reprint requests to Melanie Thomas, MS, MD, UCSF Department of Psychiatry, Health Psychology Division, 3333 California St., Suite 465, San Francisco, CA 94143. E-mail:

Received for publication January 30, 2012; revision received December 19, 2012.

Copyright © 2013 by American Psychosomatic Society
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