Abstract

CD4⁺ cells recovery after highly active antiretroviral therapy (HAART) was dependent of baseline values in HIV-1-infected children in Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Brazil

J.R. Romeiro, M.L. Silva, S. Cleto-Villela, B.R. Arantes, L.C. Oliveira, G. Pereira, J.A. Pinto, S.M. Elói-Santos

Federal University of Minas Gerais, Belo Horizonte, Brazil

Background: Laboratory monitoring of HIV-infected patient is crucial to establish therapy and prognosis guidelines. The optimal time to initiate antiretroviral therapy is still controversial. In children, some studies showed that baseline CD4% is predictive of antiretroviral therapy response. Others reported that the recovery is independent of baseline CD4%. In this study, we have evaluated, in children, the impact of HAART in immunologic and virologic markers of HIV progression, considering baseline CD4% values.
Methods: 242 HIV-infected children and adolescents (< 18 year-old) receiving HAART were enrolled in the study. CD4% and HIV RNA values were compared before and after (at least three months) the beginning of HAART. Immunological success was defined as achieving CD4% > 25.
Data were collected from January 1996 to December 2009 from laboratory database of treatment cohorts in Hospital das Clinicas UFMG, BRAZIL.
Wilcoxom Signed Ranks and McNemar-Bowker tests.
Results: HIV-children featured a progressive increase of their mean values of CD4+ T-cell counts and a decrease of log10 VL levels after HAART. The median baseline CD4% and log10 VL were 18.50% (±10.27) and 5.01 (±0.92), respectively. Median CD4 increased to 28.00 (±9.76) and median log10 VL decreased to 3.79 (±1.06) after HAART (p< 0.0001). The increase of CD4 was dependent of baseline counts (p< 0.001). 41% of patients with baseline CD4% < 15% reached values >25% after treatment while 63% of patients with baseline CD4% between15-25% achieved values >25%.
Conclusions: Children under HAART presented substantial increase in CD4% values along with significant decrease in viral load, and the recovery of CD4 level was dependent of baseline CD4%.
Financial support: FAPEMIG