Viral Load and CD4+ T Lymphocyte Response to Highly Active Antiretroviral Therapy in Human Immunodeficiency Virus Type 1-Infected Children: An Observational Study

• Published in: Clinical infectious diseases 2003-11, Vol.37 (9), p.1216-1225
• Main Authors: Resino, Salvador, Bellòn, José M., Gurbindo, Dolores, Ramos, José Tomás, Leòn, Juan Antonio, Mellado, M. Jose, Mu∼oz-Fernández, M. Ángeles
• Format: Article
• Language: English
• Subjects: AIDS; Anti-HIV Agents - adverse effects; Anti-HIV Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiretroviral Therapy, Highly Active; Antiretrovirals; Antiviral agents; Biological and medical sciences; CD4-Positive T-Lymphocytes - immunology; Child; Child health services; Children; Highly active antiretroviral therapy; HIV; HIV 1; HIV Infections - drug therapy; HIV Infections - immunology; HIV Infections - virology; HIV-1 - physiology; HIV/AIDS; Human viral diseases; Humans; Infectious diseases; Medical sciences; Pharmacology. Drug treatments; Regression Analysis; T lymphocytes; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral Load; Virology
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/378804

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.