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Low immunologic response to highly active antiretroviral therapy in naive vertically human immunodeficiency virus

Salvador Resino1, Alejandro Alvaro-Meca, Maria Isabel de José

  • 1Laboratorio de Inmuno-Biología Molecular, Hospital General Universitario Gregorio Marañón, Madrid, Spain. sresino.hgugm@salud.madrid.org

The Pediatric Infectious Disease Journal
|March 29, 2006
PubMed

Insights

Starting highly active antiretroviral therapy (HAART) in children with severe HIV immunosuppression may not restore normal CD4 counts. Children with very low baseline CD4 levels (<15%) did not achieve significant recovery after four years of HAART.

Area of Science:

  • Pediatric Infectious Diseases
  • Immunology
  • Virology

Background:

  • Vertical human immunodeficiency virus (HIV) infection in children can lead to severe immunodeficiency.
  • Early initiation of highly active antiretroviral therapy (HAART) is crucial for managing HIV infection.
  • Assessing CD4 recovery in severely immunocompromised children on HAART is essential for understanding treatment efficacy.

Purpose of the Study:

  • To analyze the CD4 T-cell recovery in naive, vertically HIV-infected children with severe immunodeficiency.
  • To evaluate the long-term effectiveness of HAART in restoring CD4 counts in this vulnerable population.

Main Methods:

  • Retrospective study design.
  • Analysis of CD4 counts in vertically HIV-infected children with severe immunodeficiency.
  • Follow-up of patients receiving HAART for at least 4 years.

Main Results:

  • Children with baseline CD4 counts below 15% did not achieve a mean CD4 count of 25% or higher after 4 years of HAART.
  • Limited CD4 recovery was observed in children who started HAART with severe immunosuppression.

Conclusions:

  • Initiating HAART in naive HIV-infected children with established severe immunosuppression may not lead to adequate CD4 count recovery.
  • Delayed treatment initiation in pediatric HIV can result in persistent immunodeficiency despite HAART.

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