CD8+ T-cell numbers predict the response to antiviral therapy in HIV-1-infected children.
Our objective was to study the probability of achieving undetectable viral load levels in HIV-1-infected children after 36 mo of highly active antiretroviral therapy (HAART). A prospective, multicenter, longitudinal study in 41 HIV-1-infected children on HAART was undertaken. Viral load was quantified using standard molecular assay. CD4+ and CD8+ T cell subsets were determined by flow cytometry. The probability of achieving undetectable viral load was determined using Kaplan-Meier curves according to groups by percentage CD8+ at baseline (CD8+ <25% or >25%). Lower baseline CD8+ T cell levels conditioned a less effective virological response to HAART in children, independent of baseline CD4+ T cell numbers and viral load levels. A greater number of children (81%) from CD8+ >25% group than from the CD8+ <25% (40%) presented undetectable viral load levels (p = 0.013). Additionally, the CD8+ >25% group showed a 4.5-fold higher (95% confidence interval: 1.1-19.2) relative proportion for achieving viral load <400 copies/mL than the CD8+ <25% group (p = 0.039). We concluded that monitoring CD8+ T cell numbers may be valuable in deciding when to start HAART in vertically HIV-1-infected children.
Resino
Slavador
S
Department of Immunology, General University Hospital Gregorio Marañón, Madrid, Spain.
Bellón
José Maria
JM
Sánchez-Ramón
Silvia
S
Gurbindo
Dolores
D
León
Juan Antonio
JA
Muñoz-Fernández
Maria Angeles
MA
D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D016516:CD4-CD8 Ratio; D015496:CD4-Positive T-Lymphocytes / Q000378:metabolism; D018414:CD8-Positive T-Lymphocytes / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy*; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D018655:Lymphocyte Count; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016176:T-Lymphocyte Subsets / Q000378:metabolism; D019562:Viral Load