Natural history of HIV infected pediatric long-term or slow progressor population after the first decade of life.
BACKGROUND
Perinatally infected long-term nonprogressors/slow progressors represent a select group of individuals. There is very limited information on this group of children beyond the first decade of life. A group of HIV-infected long-term nonprogressor/slow progressor children was studied.


METHODS
We enrolled 20 HIV-infected adolescents who were receiving no or minimal therapy (defined as single or dual nucleoside therapy) before the age of 10 years and who had maintained CD4 counts above 25% for the first decade of life. We analyzed immunologic and virologic characteristics. Thymic receptor excision circles (TREC) were measured on stored frozen peripheral blood mononuclear cells. CD4 count, viral load and other pertinent information including race and age were obtained from individual medical records.


RESULTS
Nine of the 20 patients recruited were noted to have developed falling CD4 counts at or around puberty, whereas the other 11 remained stable. There was no difference in TREC values or HIV RNA values before or after puberty between the 2 groups of patients. Those who remained stable, in terms of maintaining CD4 T cells as a group had falling viral loads with age. Those whose CD4 values declined after puberty had viral loads that did not decrease with age.


CONCLUSIONS
A select group of patients who never received HAART during their first decade of life will continue to maintain good CD4 associated with declining HIV RNA values. Thymic output is not predictive of those that don't maintain CD4 T cells.
Ofori-Mante
Juliana A
JA
Department of Pediatrics, Division of Infectious Diseases, New York University School of Medicine, 550 First Avenue, New York, NY 10016, USA.
Kaul
Aditya
A
Rigaud
Mona
M
Fidelia
Andre
A
Rochford
Gemma
G
Krasinski
Keith
K
Chandwani
Sulachni
S
Borkowsky
William
W
D000293:Adolescent; D000375:Aging; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D002648:Child; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D013950:Thymus Gland / Q000276:immunology / Q000473:pathology
D019380:Anti-HIV Agents