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Título: | Prognostic factors of a lower CD4/CD8 ratio in long term viral suppression HIV infected children |
Autor: | Guillén, Sara; Prieto, Luís; Jiménez de Ory, Santiago; Gonzalez-Tome, Maria I.; Rojo, Pablo; Navarro Gómez, María Luisa; Mellado, Maria Jose; Escosa-García, Luis; Sainz, Talia; Francisco, Laura; Muñoz-Fernández, María Ángeles CSIC ORCID; Ramos, José Tomás | Fecha de publicación: | 5-ago-2019 | Editor: | Public Library of Science | Citación: | PLoS ONE 14(8): e0220552 (2019) | Resumen: | [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). |
Descripción: | CoRISpe (Cohorte Nacional de VIH pediátrica de la RED RIS). | Versión del editor: | https://doi.org/10.1371/journal.pone.0220552 | URI: | http://hdl.handle.net/10261/212620 | DOI: | 10.1371/journal.pone.0220552 | E-ISSN: | 1932-6203 |
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