Journal Article

Antimicrobial-Specific Cell-Mediated Immune Reconstitution in Children with Advanced Human Immunodeficiency Virus Infection Receiving Highly Active Antiretroviral Therapy

Adriana Weinberg, Savita Pahwa, Rebecca Oyomopito, Vincent J. Carey, Bonnie Zimmer, Lynne Mofenson, Andrea Kovacs and Sandra K. Burchett

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 39, issue 1, pages 107-114
Published in print July 2004 | ISSN: 1058-4838
Published online July 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/420931
Antimicrobial-Specific Cell-Mediated Immune Reconstitution in Children with Advanced Human Immunodeficiency Virus Infection Receiving Highly Active Antiretroviral Therapy

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To identify virological and immunological correlates of microbial-specific immune reconstitution in children with advanced human immunodeficiency virus (HIV) infection, Candida- and tetanus-specific lymphocyte proliferation was measured in 165 children initiating a new highly active antiretroviral therapy (HAART) regimen. During the study, the proportions of children with immunity to Candida and tetanus increased from 53% to 66% and 19% to 22%, respectively. Tetanus immunity was associated with an HIV load ⩽400 RNA copies/mL and with Candida immunity. At the end of the study, 23% of the patients with baseline negative lymphocyte proliferation had tetanus immunity, and 65% had Candida immunity. Reconstitution of tetanus immunity correlated with lower end-of-study HIV loads and activated CD8+ cell percentages and higher baseline and in-study CD4+ cell percentages, but not with a gain of CD4+ cells. Reconstitution of Candida immunity showed similar trends. In conclusion, children with advanced HIV infection receiving HAART reconstituted Candida immunity more readily than they did tetanus immunity, suggesting a role for antigen reexposure. Additional factors for immune reconstitution were low HIV load, high CD4+ cell percentages, and low levels of activated CD8+ cells.

Journal Article.  5030 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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