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CD4+ lymphocyte-based immunologic outcomes of perinatally HIV-infected children during antiretroviral therapy

George K Siberry1, Kunjal Patel, Russell B Van Dyke

  • 1Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA. siberryg@mail.nih.gov

Journal of Acquired Immune Deficiency Syndromes (1999)
|March 23, 2011
PubMed

Insights

Antiretroviral treatment interruptions (TI) are common in perinatally HIV-infected youth. During TI, CD4 counts typically decline, but individual variability is high, necessitating further research into predictive factors.

Area of Science:

  • Pediatric HIV/AIDS research
  • Immunology
  • Antiretroviral therapy

Background:

  • Perinatally HIV-infected children are transitioning into adolescence.
  • Understanding outcomes of antiretroviral treatment (ART) interruption is crucial for managing this population.

Purpose of the Study:

  • To assess the characteristics and outcomes of ART interruption (TI) in perinatally HIV-infected children.
  • To identify factors associated with CD4 T-lymphocyte count changes during TI.

Main Methods:

  • Prospective cohort study of 7- to 16-year-old perinatally HIV-infected children.
  • TI defined as ART discontinuation for ≥ 3 months.
  • Linear regression analysis to determine factors related to CD4 slope during TI.

Main Results:

  • 23% of eligible subjects experienced at least one TI.
  • Median CD4% slope was -0.66% per month and CD4 count slope was -12.7 cells/mm³ per month during TI.
  • Factors like female sex, higher CD4% at TI, and higher peak viral load before TI showed trends associated with faster CD4% decline.

Conclusions:

  • ART interruptions are frequent in perinatally HIV-infected youth.
  • CD4 values generally decrease during TI, but with significant inter-individual variability.
  • Further investigation is needed to understand factors predicting CD4 slope during TI.
Abstract

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