title: Early highly active antiretroviral therapy enhances B-cell longevity: a 5 year follow up.
abstract: BACKGROUND
  We have previously reported that an early initiation of highly active antiretroviral therapy (HAART) in HIV-1 vertically infected children enhanced the function of memory B-cells gained during childhood routine vaccinations. On the other hand, a significant waning of immunity was observed for patients with a late treatment. In this follow-up study, we report data from a sample of patients in our cohort including late-treated patients being revaccinated with routine childhood vaccines.
  
  
  METHODS
  The levels of serum antibodies and cellular immunity were measured by antigen-specific enzyme-linked immunosorbent assay and B-cell ELISpot. Moreover, flow cytometry on the frequencies of mature-activated (CD10-CD21-) and double-negative (CD27-IgD-) B-cells as hallmarks of immune activation and immune senescence, respectively, was performed for all patients.
  
  
  RESULTS
  Reduced protective humoral immunity and cellular immunity to routine childhood vaccines was observed in late-treated patients. Moreover, we found that timing of HAART related with the frequencies of mature activated and double negative.
  
  
  CONCLUSIONS
  Altogether the data presented in this follow-up study reenforce the importance for an early start of HAART in HIV-1 vertically infected individuals and suggest that timing of HAART is a fundamental factor to take into account for vaccination design in this population.
authors.affiliation: From the *University Department of Pediatrics, DPUO, Unit of Immune and Infectious Diseases, Bambino Gesù Children's Hospital, Piazza S. Onofrio; †Department of Public Health, University of Rome, Tor Vergata, Rome; and ‡Department of Pediatrics, University of Padova, Padova, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Cagigi
authors.forename: Stefano
authors.initials: S
authors.lastname: Rinaldi
authors.forename: Nicola
authors.initials: N
authors.lastname: Cotugno
authors.forename: Emma Concetta
authors.initials: EC
authors.lastname: Manno
authors.forename: Veronica
authors.initials: V
authors.lastname: Santilli
authors.forename: Nadia
authors.initials: N
authors.lastname: Mora
authors.forename: Paola
authors.initials: P
authors.lastname: Zangari
authors.forename: Angela
authors.initials: A
authors.lastname: Aquilani
authors.forename: Kuekou Hyppolite
authors.initials: KH
authors.lastname: Tchidjou
authors.forename: Carlo
authors.initials: C
authors.lastname: Giaquinto
authors.forename: Stefania
authors.initials: S
authors.lastname: Bernardi
authors.forename: Paolo
authors.initials: P
authors.lastname: Rossi
authors.forename: Paolo
authors.initials: P
authors.lastname: Palma
mesh_terms: D000293:Adolescent; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D000906:Antibodies / Q000097:blood; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D001402:B-Lymphocytes / Q000276:immunology* / Q000502:physiology; D002470:Cell Survival; D002648:Child; D004797:Enzyme-Linked Immunosorbent Assay; D058501:Enzyme-Linked Immunospot Assay; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D008297:Male; D013997:Time Factors; D014612:Vaccines / Q000008:administration & dosage / Q000276:immunology*; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents; D000906:Antibodies; D014612:Vaccines