Continuous improvement in the immune system of HIV-infected children on prolonged antiretroviral therapy.

Published

Journal Article

BACKGROUND:The goal of HAART is to promote reconstitution of CD4+ T cells and other immune responses. We evaluated the extent and the kinetics of immune reconstitution in HIV-infected children over 144 weeks of successful HAART. METHODS:Thirty-seven children receiving their first HAART regimen had plasma HIV RNA; T cells and subpopulations; T-cell rearrangement excision circles (TREC) DNA; candida, HIVCD4 and HIVCD8 enzyme-linked immunospot measured at regular intervals. RESULTS:Plasma HIV RNA became undetectable in 81% of patients at 24 weeks and remained undetectable in 77% at 144 weeks. In contrast, CD4+% continuously increased. Distribution of T-cell subpopulations changed rapidly during the first 48 weeks of HAART and more slowly thereafter. At 144 weeks, total, naive and activated CD4+% and naive CD8+% of HIV-infected children were not significantly different from those of healthy age-matched controls, whereas total and activated CD8+% remained elevated. CD4 and CD8 TREC content increased only during the first 48 weeks of HAART. They positively correlated with each other and with total CD4+%, naive CD4+% and naive CD8+%. Candida and HIVCD4 enzyme-linked immunospot increased over time reaching peak values at 48 weeks and 144 weeks, respectively. HIVCD8 enzyme-linked immunospot decreased in magnitude over 144 weeks of HAART but retained its breadth. Baseline CD4+% positively correlated with CD4+% and with functional immune reconstitution at week 144, whereas baseline TREC correlated with TREC at week 144. CONCLUSION:HIV-infected children acquired normal distribution of CD4 T cells and other subpopulations and recovered CD4-mediated HIV immunity after 144 weeks of HAART.

Full Text

Duke Authors

Cited Authors

  • Weinberg, A; Dickover, R; Britto, P; Hu, C; Patterson-Bartlett, J; Kraimer, J; Gutzman, H; Shearer, WT; Rathore, M; McKinney, R; PACTG 1021 team,

Published Date

  • November 2008

Published In

Volume / Issue

  • 22 / 17

Start / End Page

  • 2267 - 2277

PubMed ID

  • 18981766

Pubmed Central ID

  • 18981766

Electronic International Standard Serial Number (EISSN)

  • 1473-5571

International Standard Serial Number (ISSN)

  • 0269-9370

Digital Object Identifier (DOI)

  • 10.1097/QAD.0b013e3283189bb3

Language

  • eng