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HIV-infected children with moderate/severe immune-suppression: changes in the immune system after highly active

S Resino1, I Galán, A Pérez

  • 1Immunobiology Molecular Laboratory, Hospital General Universitario Gregorio Maranón Madrid, Spain.

Clinical and Experimental Immunology
|August 24, 2004
PubMed

Insights

Highly active antiretroviral therapy (HAART) improved immune function in HIV-infected children by increasing T cell receptor excision circle (TREC) levels and naive T cell counts. This immune reconstitution led to better responses to mitogens and cytokines after one year of treatment.

Area of Science:

  • Immunology
  • Virology
  • Pediatrics

Background:

  • HIV infection in children leads to moderate or severe immunodeficiency.
  • Highly active antiretroviral therapy (HAART) is a standard treatment for pediatric HIV.
  • Monitoring immune system changes after HAART is crucial for assessing treatment efficacy.

Purpose of the Study:

  • To monitor immune system changes in HIV-infected children with immunodeficiency after HAART.
  • To evaluate the impact of HAART on T cell subsets, cytokine production, and antibody levels.
  • To correlate T cell receptor excision circle (TREC) levels with immune cell counts.

Main Methods:

  • Follow-up study of 14 HIV-infected children on HAART over approximately 11.8 months.
  • Measurement of T cell receptor excision circle (TREC) levels, viral load (VL), and CD4(+) and CD8(+) T cell subsets.
  • Assessment of lymphoproliferative responses to pokeweed mitogen (PWM) and cytokine production (TNF-alpha, IFN-gamma).
  • Quantification of IgG, IgG(1), and IgG(3) plasma levels.

Main Results:

  • TREC levels significantly increased after HAART, correlating positively with CD4(+) T cell counts and percentages.
  • Naive CD4(+) and CD8(+) T cell subsets increased significantly, with some subsets reaching control group levels.
  • Lymphoproliferative responses and cytokine production (TNF-alpha, IFN-gamma) recovered to normal levels after one year on HAART.
  • Viral load did not change significantly, while IgG, IgG(1), and IgG(3) levels decreased.

Conclusions:

  • HAART induces immune system reconstitution in HIV-infected children.
  • Immune recovery is characterized by decreased immune activation and reconstitution of naive T cells, likely of thymic origin.
  • TREC levels serve as a valuable indicator of immune reconstitution in pediatric HIV patients on HAART.

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