Prognostic factors of a lower CD4/CD8 ratio in long term viral suppression HIV infected children.
PLoS One
; 14(8): e0220552, 2019.
Article
en En
| MEDLINE
| ID: mdl-31381604
ABSTRACT
BACKGROUND:
Combination antiretroviral therapy (cART) is associated with marked immune reconstitution. Although a long term viral suppression is achievable, not all children however, attain complete immunological recovery due to persistent immune activation. We use CD4/CD8 ratio like a marker of immune reconstitution.METHODS:
Perinatal HIV-infected children who underwent a first-line cART, achieved viral suppression in the first year and maintained it for more than 5 years, with no viral rebound were included. Logistic models were applied to estimate the prognostic factors, clinical characteristics at cART start, of a lower CD4/CD8 ratio at the last visit.RESULTS:
146 HIV-infected children were included 77% Caucasian, 45% male and 28% CDC C. Median age at cART initiation was 2.3 years (IQR 0.5-6.2). 42 (30%) children received mono-dual therapy previously to cART. Time of undetectable viral load was 9.5 years (IQR 7.8, 12.5). 33% of the children not achieved CD4/CD8 ratio >1. Univariate analysis showed an association between CD4/CD8 <1 with lower CD4 nadir and baseline CD4; older age at diagnosis and at cART initiation; and a previous exposure to mono-dual therapy. Multivariate analysis also revealed relationship between CD4/CD8 <1 and lower CD4 nadir (OR 1.002, CI 95% 1.000-1.004) as well as previous exposure to mono-dual therapy (OR 0.16, CI 95% 0.003-0.720).CONCLUSIONS:
CD4/CD8 >1 was not achieved in 33% of the children. Lower CD4 nadir and previous exposure to suboptimal therapy, before initiating cART, are factors showing independently association with a worse immune recovery (CD4/CD8 < 1).
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Infecciones por VIH
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VIH-1
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Relación CD4-CD8
/
Terapia Antirretroviral Altamente Activa
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
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Child
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Child, preschool
/
Female
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Humans
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Infant
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Male
/
Newborn
Idioma:
En
Revista:
PLoS One
Asunto de la revista:
CIENCIA
/
MEDICINA
Año:
2019
Tipo del documento:
Article
País de afiliación:
España