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Immunoreconstitution after ritonavir therapy in children with human immunodeficiency virus infection involves multiple lymphocyte lineages

  1. Author:
    Sleasman, J. W.
    Nelson, R. P.
    Goodenow, M. M.
    Wilfret, D.
    Hutson, A.
    Baseler, M.
    Zuckerman, J.
    Pizzo, P. A.
    Mueller, B. U.

  2. Author Address

    Sleasman JW Univ Florida, Coll Med, Dept Pediat, Div Infect Dis & Immunol Box 100296 Gainesville, FL 32610 USA Univ Florida, Coll Med, Dept Pediat, Div Infect Dis & Immunol Gainesville, FL 32610 USA Univ Florida, Coll Med, Dept Pathol & Lab Med Gainesville, FL 32610 USA Univ S Florida, All Childrens Hosp, Coll Med, Dept Pediat St Petersburg, FL 33701 USA Univ Florida, Dept Stat, Div Biostat Gainesville, FL USA Sci Applicat Int Corp Ctr Frederick, MD USA NCI, HIV & AIDS Malignancy Branch Bethesda, MD USA
    1. Year: 1999
  2. Journal: Journal of Pediatrics
    1. 134
    2. 5
    3. Pages: 597-606
  4. Type of Article: Article
  1. Abstract:

    Objective: To evaluate lymphocyte reconstitution after protease inhibitor therapy in children with human immunodeficiency virus (HIV) infection. Study design: Forty-four HIV-infected children receiving ritonavir monotherapy followed by the addition of zidovudine and didanosine were evaluated during a phase I/II clinical trial. The cohort had a median age of 6.8 years and advanced disease (57% Centers for Disease Control and Prevention stage C, 73% immune stage 3) and was naive to protease inhibitor therapy. Results: After 4 weeks of therapy, there was a significant increase in CD4(+) and CD8(+) T cells. CD4(+) T cells continued to increase, whereas CD8(+) T cells returned to baseline by 24 weeks. Unexpectedly, there was a significant increase in B cells. Changes in CD4(+) T-cell subsets revealed an initial increase in CD4(+) CD45RO T cells followed by a sustained increase in CD4(+) CD45RA T cells. Children <6 years of age had the highest increase in all lymphocyte populations. Significant improvement in CD4(+) T-cell counts was observed even in those children whose viral burden returned to pretherapy levels. Conclusions: Early increases in lymphocytes after ritonavir therapy are a result of recirculation, as shown by increases in B cells and CD4(+) CD45RO and CD8(+) T cells. Children exhibited a high potential to reconstitute CD4(+) CD45RA T cells even with advanced disease and incomplete viral suppression. [References: 47]

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