Treatment-resistant expansion of CD8+CD28-cells in pediatric HIV infection.
There is a disease stage-dependent loss of CD28 expression on T cells in HIV-infected children. In this study, T cell recovery, in particular CD28 expression on T cells, was analyzed after initiation of highly active antiretroviral therapy in a group of eight mostly treatment-naive HIV-infected children. Plasma HIV-RNA levels were recorded, and numbers of CD4, CD8, CD4+CD28+, and CD8+CD28+ cells were determined by two-color flow cytometry. Values after 12 mo of therapy were compared with age-matched, seronegative control subjects. CD4 recovery to subnormal values was observed in all children. CD8+CD28+ cells recovered and were within the normal range after 12 mo of therapy (patients, 703 +/- 250 cells/microL; controls, 789 +/- 269 cells/microL), whereas CD8+CD28- cells (546 +/- 269 cells/microL) remained significantly expanded compared with age-matched controls (140 +/- 35 cells/microL). Expansions of CD8+CD28- cells persisted even in cases with long-term suppression of viral replication. Highly active antiretroviral therapy in HIV-infected children induces substantial but incomplete T cell recovery.
Niehues
T
T
Department of Pediatrics, Heinrich Heine University, Düsseldorf, Germany.
Horneff
G
G
Knipp
S
S
Adams
O
O
Wahn
V
V
D000293:Adolescent; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018106:CD28 Antigens / Q000032:analysis*; D018791:CD4 Lymphocyte Count; D016827:CD8 Antigens / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D005434:Flow Cytometry; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D007223:Infant; D019562:Viral Load
D019380:Anti-HIV Agents; D018106:CD28 Antigens; D016827:CD8 Antigens