title: Immunoreconstitution in children receiving highly active antiretroviral therapy depends on the CD4 cell percentage at baseline.
abstract: 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.
authors.affiliation: New York University Medical Center, New York, NY 10016, USA.
authors.forename: Divna
authors.initials: D
authors.lastname: Nikolic-Djokic
authors.forename: Shaffiq
authors.initials: S
authors.lastname: Essajee
authors.forename: Mona
authors.initials: M
authors.lastname: Rigaud
authors.forename: Aditya
authors.initials: A
authors.lastname: Kaul
authors.forename: Sulachni
authors.initials: S
authors.lastname: Chandwani
authors.forename: William
authors.initials: W
authors.lastname: Hoover
authors.forename: Robert
authors.initials: R
authors.lastname: Lawrence
authors.forename: Henry
authors.initials: H
authors.lastname: Pollack
authors.forename: Yekaterina
authors.initials: Y
authors.lastname: Sitnitskaya
authors.forename: Stefan
authors.initials: S
authors.lastname: Hagmann
authors.forename: Patrick
authors.initials: P
authors.lastname: Jean-Philippe
authors.forename: Song He
authors.initials: SH
authors.lastname: Chen
authors.forename: Jayme
authors.initials: J
authors.lastname: Radding
authors.forename: Keith
authors.initials: K
authors.lastname: Krasinski
authors.forename: William
authors.initials: W
authors.lastname: Borkowsky
mesh_terms: 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
chemical_list: D012367:RNA, Viral