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CD4:CD8 ratio in children with perinatally acquired HIV‐1 infection

OBJECTIVES: In adults with horizontally acquired HIV infection, an inverted CD4:CD8 ratio is associated with persistent immune activation, size of HIV reservoir and predicts an increased risk of non‐AIDS‐defining adverse events. Normalization of this ratio with antiretroviral therapy (ART) is subopt...

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Autores principales: Seers, T, Vassallo, P, Pollock, K, Thornhill, JP, Fidler, S, Foster, C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6221101/
https://www.ncbi.nlm.nih.gov/pubmed/30084150
http://dx.doi.org/10.1111/hiv.12642
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author Seers, T
Vassallo, P
Pollock, K
Thornhill, JP
Fidler, S
Foster, C
author_facet Seers, T
Vassallo, P
Pollock, K
Thornhill, JP
Fidler, S
Foster, C
author_sort Seers, T
collection PubMed
description OBJECTIVES: In adults with horizontally acquired HIV infection, an inverted CD4:CD8 ratio is associated with persistent immune activation, size of HIV reservoir and predicts an increased risk of non‐AIDS‐defining adverse events. Normalization of this ratio with antiretroviral therapy (ART) is suboptimal in adults, despite viral suppression, and is less well described in paediatric populations. We investigated rates of CD4:CD8 ratio recovery in children with perinatally acquired HIV infection (PaHIV) on ART. METHODS: A cross‐sectional, retrospective analysis of routine clinical data in children with PaHIV (5–18 years old) attending a single UK centre was carried out. RESULTS: CD4:CD8 normalization was seen in 62% of children on suppressive ART. A negative correlation was found between current CD4:CD8 ratio and age at start of ART. Positive correlations were found between current CD4:CD8 ratio and total time with suppressed HIV viral load and nadir CD4 counts. Multiple linear regression analysis showed that age at start of ART was significantly associated with current CD4:CD8 ratio (standardized β = −0.680; P < 0.001). Patient sex, ethnicity and antiretroviral regimen did not affect ratio recovery. CONCLUSIONS: We found higher rates of CD4:CD8 ratio normalization compared with previous adult studies. Children who started ART at a younger age were more likely to recover a normal ratio. The current policy of universal treatment for all HIV‐positive adults and children will enhance immunological normalization.
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spelling pubmed-62211012018-11-15 CD4:CD8 ratio in children with perinatally acquired HIV‐1 infection Seers, T Vassallo, P Pollock, K Thornhill, JP Fidler, S Foster, C HIV Med Short Communications OBJECTIVES: In adults with horizontally acquired HIV infection, an inverted CD4:CD8 ratio is associated with persistent immune activation, size of HIV reservoir and predicts an increased risk of non‐AIDS‐defining adverse events. Normalization of this ratio with antiretroviral therapy (ART) is suboptimal in adults, despite viral suppression, and is less well described in paediatric populations. We investigated rates of CD4:CD8 ratio recovery in children with perinatally acquired HIV infection (PaHIV) on ART. METHODS: A cross‐sectional, retrospective analysis of routine clinical data in children with PaHIV (5–18 years old) attending a single UK centre was carried out. RESULTS: CD4:CD8 normalization was seen in 62% of children on suppressive ART. A negative correlation was found between current CD4:CD8 ratio and age at start of ART. Positive correlations were found between current CD4:CD8 ratio and total time with suppressed HIV viral load and nadir CD4 counts. Multiple linear regression analysis showed that age at start of ART was significantly associated with current CD4:CD8 ratio (standardized β = −0.680; P < 0.001). Patient sex, ethnicity and antiretroviral regimen did not affect ratio recovery. CONCLUSIONS: We found higher rates of CD4:CD8 ratio normalization compared with previous adult studies. Children who started ART at a younger age were more likely to recover a normal ratio. The current policy of universal treatment for all HIV‐positive adults and children will enhance immunological normalization. John Wiley and Sons Inc. 2018-08-06 2018-10 /pmc/articles/PMC6221101/ /pubmed/30084150 http://dx.doi.org/10.1111/hiv.12642 Text en © 2018 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Short Communications
Seers, T
Vassallo, P
Pollock, K
Thornhill, JP
Fidler, S
Foster, C
CD4:CD8 ratio in children with perinatally acquired HIV‐1 infection
title CD4:CD8 ratio in children with perinatally acquired HIV‐1 infection
title_full CD4:CD8 ratio in children with perinatally acquired HIV‐1 infection
title_fullStr CD4:CD8 ratio in children with perinatally acquired HIV‐1 infection
title_full_unstemmed CD4:CD8 ratio in children with perinatally acquired HIV‐1 infection
title_short CD4:CD8 ratio in children with perinatally acquired HIV‐1 infection
title_sort cd4:cd8 ratio in children with perinatally acquired hiv‐1 infection
topic Short Communications
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6221101/
https://www.ncbi.nlm.nih.gov/pubmed/30084150
http://dx.doi.org/10.1111/hiv.12642
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