title: Long-term protease inhibitor-containing therapy results in limited improvement in T cell function but not restoration of interleukin-12 production in pediatric patients with AIDS.
abstract: This study investigated whether immune restoration occurred in 26 human immunodeficiency virus (HIV) type 1-infected children treated first with indinavir for 16 weeks and then with combination antiretroviral therapy for >2 years. Compared with baseline, a significant, although modest, decrease in virus loads (maximum median, -0.86 log(10)) and increase in the number of CD4(+) lymphocytes, especially naive cells, were observed at several time points after 2 years. A maximum of 7% of treated children achieved undetectable viremia. There was a marked increase in the proliferative response and skin reactivity to recall antigens. However, responses to an HIV antigen remained depressed, and the production of interleukin-12 remained unchanged and abnormally low. The magnitude of virus suppression did not correlate with these measures of functional immune reconstitution. These findings suggest that long-term nonsuppressive antiretroviral therapy can induce limited improvement in immune function in pediatric AIDS patients and that the effect of suppressive treatments should be investigated.
authors: Experimental Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA. chougnet@ihmi.edu
authors: C
authors: C
authors: Chougnet
authors: S
authors: S
authors: Jankelevich
authors: K
authors: K
authors: Fowke
authors: D
authors: D
authors: Liewehr
authors: S M
authors: SM
authors: Steinberg
authors: B U
authors: BU
authors: Mueller
authors: P A
authors: PA
authors: Pizzo
authors: R
authors: R
authors: Yarchoan
authors: G M
authors: GM
authors: Shearer
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000276:immunology; D000293:Adolescent; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D015488:HIV Antigens / Q000097:blood; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D006801:Humans; D019469:Indinavir / Q000627:therapeutic use; D018664:Interleukin-12 / Q000096:biosynthesis*; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D010835:Phytohemagglutinins / Q000097:blood; D013601:T-Lymphocytes / Q000187:drug effects* / Q000276:immunology*; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load; D015215:Zidovudine / Q000627:therapeutic use
chemical_list: D019380:Anti-HIV Agents; D015488:HIV Antigens; D017320:HIV Protease Inhibitors; D010835:Phytohemagglutinins; D018664:Interleukin-12; D019259:Lamivudine; D015215:Zidovudine; D019469:Indinavir