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Title: Reduced markers of HIV persistence and restricted HIV-specific immune responses after early antiretroviral therapy in children
Authors: Jintanat Ananworanich
Thanyawee Puthanakit
Piyarat Suntarattiwong
Kulkanya Chokephaibulkit
Stephen J. Kerr
Rémi Fromentin
Wendy Bakeman
Jintana Intasan
Apicha Mahanontharit
Sunee Sirivichayakul
Nicolas Chomont
The HIV Netherlands Australia Thailand Research Collaboration
Faculty of Medicine, Thammasat University
Chulalongkorn University
Queen Sirikit National Institute of Child Health
Mahidol University
University of New South Wales (UNSW) Australia
Vaccine and Gene Therapy Institute of Florida
Keywords: Immunology and Microbiology;Medicine
Issue Date: 24-Apr-2014
Citation: AIDS. Vol.28, No.7 (2014), 1015-1020
Abstract: OBJECTIVE:: Understanding the extent to which early antiretroviral therapy (ART) can limit the establishment and persistence of the HIV reservoir is an important step to designing interventions aimed at achieving HIV cure. We measured the markers of HIV persistence and HIV-specific immunity in early treated children. DESIGN:: This is a cross-sectional study that enrolled 15 children older than 2 years of age who initiated ART before 6 months of age and had sustained viral suppression. Total and integrated HIV DNA, and 2-LTR circles in CD4 T cells, HIV antibody response by fourth generation HIV enzyme immunoassay, and CD4 and CD8 T-cell responses to gag/env peptides by intracellular cytokine staining of CD4 and CD8 T cells were measured. RESULTS:: The median current age was 6.3 years and age at ART initiation was 17 weeks. The median duration of viral suppression was 6 years, and all had HIV RNA less than 50aScopies/ml. The median CD4 T cells was 44%. The median total HIV DNA was 132aŠcopies/10 CD4 T cells (range 11-1804) and integrated HIV DNA was 17aScopies/10 CD4 T cells (range 0-516), and no one had detectable 2-LTR circles. Nine of the 15 children (60%) had undetectable or extremely low integrated HIV DNA (<20acopies/10 CD4 T cells). All except one (93%) had undetectable HIV-specific CD4/CD8 cell responses and seven (47%) had nonreactive enzyme immunoassay. CONCLUSION:: Early ART resulted in very low levels of markers of HIV persistence and undetectable HIV-specific immune responses in the majority of HIV-infected children who started ART before 6 months of age. © 2014 Wolters Kluwer Health.
ISSN: 14735571
Appears in Collections:Scopus 2011-2015

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