title: Early antiretroviral therapy in children perinatally infected with HIV: a unique opportunity to implement immunotherapeutic approaches to prolong viral remission.
abstract: From the use of antiretroviral therapy to prevent mother-to-child transmission to the possibility of HIV cure hinted at by the Mississippi baby experience, paediatric HIV infection has been pivotal to our understanding of HIV pathogenesis and management. Daily medication and indefinite antiretroviral therapy is recommended for children infected with HIV. Maintenance of life-long adherence is difficult and the incidence of triple-class virological failure after initiation of antiretroviral therapy increases with time. This challenge shows the urgent need to define novel strategies to provide long-term viral suppression that will allow safe interruption of antiretroviral therapy without viral rebound and any associated complications. HIV-infected babies treated within a few days of birth have a unique combination of a very small pool of integrated viruses, a very high proportion of relatively HIV resistant naive T cells, and an unparalleled capacity to regenerate an immune repertoire. These features make this group the optimum model population to investigate the potential efficacy of immune-based therapies. If successful, these investigations could change the way we manage HIV infection.
authors.affiliation: Institute of Child Health, University College London, London, UK. Electronic address: n.klein@ucl.ac.uk.
authors.forename: Nigel
authors.initials: N
authors.lastname: Klein
authors.affiliation: University Department of Pediatrics, Unit of Immune and Infectious Diseases, Children's Hospital Bambino Gesù, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Palma
authors.affiliation: Program in Molecular Medicine, University of Massachusetts Medical School Worcester, MA, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Luzuriaga
authors.affiliation: Miami Center for AIDS Research Department of Microbiology and Immunology, University of Miami, Miller School of Medicine, Miami, FL, USA.
authors.forename: Savita
authors.initials: S
authors.lastname: Pahwa
authors.affiliation: Department of Virology, University College London, London, UK.
authors.forename: Eleni
authors.initials: E
authors.lastname: Nastouli
authors.affiliation: Medical Research Council Clinical Trials Unit, London, UK.
authors.forename: Diane M
authors.initials: DM
authors.lastname: Gibb
authors.affiliation: Department of Pediatrics, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Rojo
authors.affiliation: New York University School of Medicine, New York, NY, USA.
authors.forename: William
authors.initials: W
authors.lastname: Borkowsky
authors.affiliation: University Department of Pediatrics, Unit of Immune and Infectious Diseases, Children's Hospital Bambino Gesù, Rome, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Bernardi
authors.affiliation: University Department of Pediatrics, Unit of Immune and Infectious Diseases, Children's Hospital Bambino Gesù, Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Zangari
authors.affiliation: Pierre et Marie Curie University and Pitié-Salpêtrière Hospital, Paris, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Calvez
authors.affiliation: Institut National de la Santé et de la Recherche Médicale SC10-US019 Clinical Trials and Infectious Diseases, Villejuif, Paris, France.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Compagnucci
authors.affiliation: Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Britta
authors.initials: B
authors.lastname: Wahren
authors.affiliation: Imperial College Healthcare National Health Service Trust, London, UK.
authors.forename: Caroline
authors.initials: C
authors.lastname: Foster
authors.affiliation: Department of Molecular ImmunoBiology, Hospital General Universitario Gregorio Maraňon, Madrid, Spain.
authors.forename: María Ángeles
authors.initials: MÁ
authors.lastname: Munoz-Fernández
authors.affiliation: Section of Oncology and Immunology, Department of Surgery, Oncology and Gastroenterology-DiSCOG, University of Padova, and Istituto Oncologico Veneto, Padova, Italy.
authors.forename: Anita
authors.initials: A
authors.lastname: De Rossi
authors.affiliation: US Military HIV Research Program, Walter Reed Army Institute of Research and Henry M Jackson Foundation for the Advancement of Military Medicine, Silver Spring, MD, USA.
authors.forename: Jintanat
authors.initials: J
authors.lastname: Ananworanich
authors.affiliation: Africa Centre, Mtubatuba, KwaZulu Natal, South Africa.
authors.forename: Deenan
authors.initials: D
authors.lastname: Pillay
authors.affiliation: Department of Women's and Children's Health, University of Padova, and Penta Foundation, Padova, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Giaquinto
authors.affiliation: University Department of Pediatrics, Unit of Immune and Infectious Diseases, Children's Hospital Bambino Gesù, Rome, Italy. Electronic address: rossipa@uniroma2.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Rossi
mesh_terms: D000293:Adolescent; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D061345:Early Medical Intervention; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000635:transmission*; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D014765:Viral Vaccines
chemical_list: D044966:Anti-Retroviral Agents; D014765:Viral Vaccines