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Abstract
EFFECT OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY IN INFANTS UPON IMMUNE RECONSTITUTION
PAHWA S, KHARBANDA M, CHAVAN S
Rationale: Infants constitute an ideal population for investigating the immunologic and virologic consequences of HAART in primary HIV infection. Although long-term viral suppression in infants is accompanied with preservation of CD4 T cells, HIV specific immune responses are not detected, which is in contrast to adults given HAART early in HIV infection. In this study we evaluated the effect of HAART (3-4 antiretroviral drugs) on immune reconstitution in infants with perinatal HIV infection.
Methods: 10 HIV infected infants (mean age ± SD 4.9±3.5 mo.) with mean plasma virus load of 4.2±1.1 log10 HIV RNA copies/ml and mean CD4 count of 38.6±8.8% were started on HAART and evaluated longitudinally for T cell receptor excision circles (TRECs) estimated by real time PCR in PBMC using TaqMan assay, and TCR Vb repertoire by CDR3 length spectratyping in purified CD4 and CD8 T cells. Results were compared to age matched HIV-exposed uninfected infants (EUI).
Results: 9 infants achieved virologic suppression at 3.5±2.7 mos. after onset of therapy. TRECs levels in HIV infected infants were significantly lower than in EUI and increased by 6-12 months of HAART, p=0.007). TCR V beta perturbations with clonal dominance was observed in CD8 T cells and involved significantly greater number of TCR V beta families in HIV infected infants as compared to EUI (p<0.019). CD8 T cell perturbations persisted until 24 mo. post therapy. Conclusions: These findings implicate residual immune perturbations in HIV infected infants given HAART early in life that persist despite increase in TRECs, virologic suppression and normal CD4 T cell counts. CD8 T cell clonal dominance is an early indicator of immune activity whereas decrease in TRECs is an early indicator of immune suppression.
This study was supported by NIH grants HD 37345 and AI 48857
The 1st. IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
135
Suggested Citation
"PAHWAS, et al.
EFFECT OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY IN INFANTS UPON IMMUNE RECONSTITUTION.
Oral Presentation:
The 1st. IAS Conference on HIV Pathogenesis and Treatment
:
Abstract no.
135"
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