Immunoreconstitution in children receiving highly active antiretroviral therapy depends on the CD4 cell percentage at baseline.
The effect of highly active antiretroviral therapy (HAART) in 85 children infected with human immunodeficiency virus type 1 (HIV-1) was compared retrospectively among Centers for Disease Control and Prevention (CDC) immunologic groups 1-3. The duration of HAART did not vary significantly among the immunologic groups (median, 39.07 months). The CD4 cell percentage increased in 39.1%, 58.3%, and 90% of patients in CDC groups 1-3, respectively (P <.001). HAART resulted in the suppression of HIV-1 below detectable levels in 34.8%, 25%, and 32% of patients in the 3 CDC groups, respectively, and in a frequent switch from syncytium-inducing to nonsyncytium-inducing virus. Thymic excision circles increased in a subset of patients with increases in CD4 cell percentage independently of HIV RNA level. The results support the option of delaying HAART in early asymptomatic HIV-1 disease in children and the use of other markers of disease progression, in addition to virus load.
Nikolic-Djokic
Divna
D
New York University Medical Center, New York, NY 10016, USA.
Essajee
Shaffiq
S
Rigaud
Mona
M
Kaul
Aditya
A
Chandwani
Sulachni
S
Hoover
William
W
Lawrence
Robert
R
Pollack
Henry
H
Sitnitskaya
Yekaterina
Y
Hagmann
Stefan
S
Jean-Philippe
Patrick
P
Chen
Song He
SH
Radding
Jayme
J
Krasinski
Keith
K
Borkowsky
William
W
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D005260:Female; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D007223:Infant; D008297:Male; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies; D019562:Viral Load
D012367:RNA, Viral