Impact of long-term viral suppression in CD4 recovery of HIV-children on Highly Active Antiretroviral TherapyReportar como inadecuado

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BMC Infectious Diseases

, 6:10

First Online: 24 January 2006Received: 12 July 2005Accepted: 24 January 2006


BackgroundThe effects of HAART may differ between children and adults because children have a developing immune system, and the long-term immunological outcome in HIV-infected children on HAART is not well-known. A major aim of our study was to determine CD4+ evolution associated with long-term VL control during 4 years of observation on HAART.

MethodsWe carried out a retrospective study on a cohort of 160 vertically HIV-infected children. It was carried out from 1996 to 2004 in six large Spanish pediatric referral hospitals. We compared 33 children who had long-term VL suppression VL ≤400 copies-ml in the first 12 months of follow-up and maintained that level throughout follow-up Responders-group, and 127 children with persistently detectable VL in spite of ART switches Non-Responders-group.

ResultsWe observed a quick initial and significant increase in CD4 counts from the baseline to 12 months on HAART in both groups p < 0.01. The Non-Responders group sustained CD4+ increases and most of these children maintained high CD4 level counts ≥25%. The Non-Responders group reached a plateau between 26% and 27% CD4 at the first 12 months of follow-up that remained stable during the following 3 years. However, the Responders group reached a plateau between 30% and 32% CD4 at 24, 36 and 48 months of follow-up. We found that the Responders group had higher CD4 count values and higher percentages of children with CD4 ≥25% than the Non-Responders group p < 0.05 after month 12.

ConclusionLong-term VL suppression in turn induces large beneficial effects in immunological responses. However, it is not indispensable to recover CD4 levels.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2334-6-10 contains supplementary material, which is available to authorized users.

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Autor: Salvador Resino - Rosa Resino - Juan A Leon - José M Bellon - Pablo Martin-Fontelos - Jose T Ramos - Dolores Gurbindo-G


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