AEGiS-13IAC: Immunological reconstitution in HIV infected newborns treated with HAART.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Immunological reconstitution in HIV infected newborns treated with HAART.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. MoOrB175)

Cancrini C, Castelli Gattinara G, Romiti L, Bernardi S, Krzysztofiak A, Rossi P
C. Cancrini, Bambino Gesu Hospital, P.S. Onofrio 4, 00165 Rome, Italy, Tel.: +39 66 859 21 90, Fax: +39 66 859 25 08, E-mail: castelli@opbg.net

BACKGROUND: Vertically HIV-1 infection is a typical model of primary infection (PHI). Several studies indicated that during PHI, high perturbations occur in CD8+ and CD4+ T lymphocytes expressing distinct Vb-genes and that their persistence is related to distinct clinical progression. The objective of this study is to evaluate the effects of early triple combination therapy (HAART) on the immune system development of HIV infected newborns.

METHODS: Fresh blood samples from two HIV infected and two uninfected newborns have been analysed and CDR3 fragment length analyses were performed at different time points.

RESULTS: The two infected newborns were classified as N1 and C2. Baseline viral load values were 624,600 (log 5.79) and 490,000 (log 4.71) copies/ml, respectively. In the first newborn, a marked reduction of viral load value was observed within 4 weeks of therapy and HIV-1 RNA copy number was undetectable (>200 copies/ml) in the following year, and the number of CD4+T cells was constant. In the second newborn, a reduction of HIV-RNA level was detected at 4 weeks (80,000 cp/ml) and an undetectable level was reached at 5 months of therapy with a good increase of CD4+T cells. At baseline, CD4 TCR repertoire was normal in the first child while was widely altered in the second one. However, the CD8 TCR distribution was deeply altered in both children. After 12 months of therapy the CD8 TCR-Vb patterns were completely normalised in the first child and partially in the second. CD4 TCR distribution resulted highly conserved during the first year of therapy in one and improved in the second.

CONCLUSIONS: Early HAART given to HIV-1 infected newborns completely restores immunological parameters after 12 months.

Keywords: AEGIS, Antiretroviral Therapy, Highly Active, HIV Infections, HIV-1, Viral Load, HIV Seropositivity, Antigens, CD8, Receptors, Antigen, T-Cell, T-Lymphocytes, Infant, Newborn, Human, Child, immunology, pathogenicity
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MoOrB175