title: Viral load and CD4+ T lymphocyte response to highly active antiretroviral therapy in human immunodeficiency virus type 1-infected children: an observational study.
abstract: An observational study was performed involving 95 children with vertically transmitted human immunodeficiency virus type 1 infection to assess the sustainability of undetectable viral loads (VLs) and increased CD4+ T lymphocyte percentages after 48 months of highly active antiretroviral therapy (HAART). The median time to achieve a 10% increase in the CD4+ T lymphocyte percentage was 11.01 months. The median time to achieve an undetectable VL was 6.4 months. At the end of the study, 64.2% of the children had achieved an undetectable VL. Of the patients with an initial VL of >3.6 log10 copies/mL, 74.7% had a decrease in the VL of 1 log10 copies/mL. By contrast, of the patients who presented with an initial VL of >4.6 log10 copies/mL, 37.9% had a decrease of >2 log10 copies/mL. Higher VL at baseline, antiretroviral therapy regimens received before HAART, and multiple drug switches while receiving antiretroviral therapy were all inversely associated with an undetectable VL. A CD4+ T lymphocyte percentage of >25% was directly associated with undetectable VL during the follow-up period. In conclusion, first-line HAART induces beneficial virological and immunological outcome responses in children.
authors.affiliation: Laboratory of Immuno-Molecular Biology, Hospital Gregorio Marañón, Madrid, Spain.
authors.forename: Salvador
authors.initials: S
authors.lastname: Resino
authors.forename: José
authors.initials: J
authors.lastname: M  Bellón
authors.forename: Dolores
authors.initials: D
authors.lastname: Gurbindo
authors.forename: José
authors.initials: J
authors.lastname: Tomás Ramos
authors.forename: Juan
authors.initials: J
authors.lastname: Antonio León
authors.forename: M
authors.initials: M
authors.lastname: Jose Mellado
authors.forename: M
authors.initials: M
authors.lastname: Angeles Muñoz-Fernández
mesh_terms: D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D002648:Child; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology* / Q000821:virology; D015497:HIV-1 / Q000502:physiology*; D006801:Humans; D012044:Regression Analysis; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents