Prognostic factors of a lower CD4/CD8 ratio in long term viral suppression HIV infected children

Sara Guillén, Luis Prieto, Santiago Jiménez de Ory, María Isabel González-Tomé, Pablo Rojo, María Luisa Navarro, María José Mellado, Luis Escosa, Talía Sainz, Laura Francisco, María Ángeles Muñoz-Fernández, José Tomás Ramos and On behalf of CoRISpe (Cohorte Nacional de VIH pediátrica de la RED RIS)

PLOS ONE, 2019, vol. 14, issue 8, 1-11

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 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

Date: 2019
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0220552

DOI: 10.1371/journal.pone.0220552

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