title: HIV-1 DNA concentrations and evolution among African HIV-1-infected children under antiretroviral treatment (ANRS 1244/1278).
abstract: OBJECTIVE
  The objectives of this study were to describe the pretreatment HIV-1 DNA concentrations in children infected with HIV and to evaluate the impact of antiretroviral therapy (ART) on HIV-DNA concentrations.
  
  
  METHODS
  This was a retrospective analysis of all children followed up in the 'Programme Enfant Yopougon' cohort, Abidjan, Côte d'Ivoire, from 2000 to 2004, who had cryopreserved peripheral blood mononuclear cells (PBMCs) and plasma samples. HIV-DNA was measured using a real-time PCR assay. Mixed-model analysis was used to analyse the factors associated with change in HIV-DNA concentration.
  
  
  RESULTS
  The study included 121 children infected with HIV-1. The median age at inclusion was 6 years (IQR: 3.5-9) and children were at an advanced stage of HIV disease (46.6% and 20.3% presenting CDC stage B and CDC stage C, respectively). At baseline, the median HIV-DNA concentration was 3.4 log₁₀ copies/10(6) PBMCs (IQR: 3.1-3.6). Fifty-four children were initiated on ART during follow-up. After 24 months of ART, HIV-DNA load decreased by 0.32 (IQR: 0.08-0.57) log₁₀ copies/10(6) PBMCs. The only factor associated with the HIV-DNA decrease was a concomitant low HIV-RNA viral load result. Children with efficient ART had a 0.51 log₁₀ copies (IQR: 0.40-0.86) HIV-DNA decrease per million PBMCs.
  
  
  CONCLUSIONS
  HIV-DNA concentrations decreased following ART initiation in a large African paediatric cohort. This decline was exclusively associated with the decrease in ongoing replication level achieved. Our study points out that a strong adherence is needed for ART to be efficient on the viral reservoirs, and further reinforces that adherence support is also essential to diminish the reservoir.
authors.affiliation: Institut de Recherche pour le Développement, University Montpellier 1, UMI 233 Montpellier, France charlotte.boulle@ird.fr.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Boullé
authors.affiliation: Retrovirology Laboratory, International Center for Medical Research of Franceville, BP769 Franceville, Gabon.
authors.forename: François
authors.initials: F
authors.lastname: Rouet
authors.affiliation: Elizabeth Glaser Pediatric AIDS Foundation, Abidjan, Côte d'Ivoire.
authors.forename: Patricia
authors.initials: P
authors.lastname: Fassinou
authors.affiliation: Institut de Recherche pour le Développement, University Montpellier 1, UMI 233 Montpellier, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Msellati
authors.affiliation: Institut de Recherche pour le Développement, University Montpellier 1, UMI 233 Montpellier, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Debeaudrap
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, EA 7327 Paris, France Assistance Publique Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Laboratoire de Virologie, Paris, France.
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Chaix
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, EA 7327 Paris, France Assistance Publique Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Laboratoire de Virologie, Paris, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Rouzioux
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, EA 7327 Paris, France Assistance Publique Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Laboratoire de Virologie, Paris, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Avettand-Fenoel
mesh_terms: D023241:Antiretroviral Therapy, Highly Active / Q000379:methods* / Q000639:trends; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D007560:Cote d'Ivoire / Q000453:epidemiology; D004279:DNA, Viral / Q000097:blood*; D019143:Evolution, Molecular; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000097:blood* / Q000188:drug therapy* / Q000453:epidemiology; D015497:HIV-1 / Q000187:drug effects / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D004279:DNA, Viral
keywords: Africa; HIV-DNA; cohort study