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Immunological
Changes after HAART with Lopinavir-Ritonavir in Heavily Pretreated
Children
Researchers evaluated the effect of
salvage antiretroviral
therapy with lopinavir/ritonavir/
LPV/r (Kaletra) on the immune system of heavily antiretroviral
pretreated HIV-infected children.
The investigators conducted a longitudinal study in 20 antiretroviral
experienced HIV-infected children to determine the changes in several
immunological parameters (T cell subsets, thymic function) every
3 months during 18 months of follow-up on salvage therapy with LPV/r.
Statistical analyses were performed with the Wilcoxon test,
taking as a reference the basal value at the entry in the study.
HIV-infected children showed an increase of CD4(+)T cells, a decrease
in CD8(+)
T cells, and an increase in T cell rearrangement excision
circle (TRECs) levels.
Results
·
The
percentage of HIV children with undetectable
viral load (VL </=400 copies/ml) increased
significantly (p = 0.007) and the percentage with SI viral phenotype
decreased significantly (p = 0.002) at the end of the study.
·
Thus,
the viral phenotype changed to NSI/R5 after salvage therapy with
LPV/r.
·
The
researchers observed a significant decrease of memory and a moderate
decrease of activated T cells during the follow-up.
·
On
the other hand, memory, activated, and effector T-cells had a very
significant decrease during follow-up.
In conclusion, the authors write, “Our data indicate an immune
system reconstitution in heavily pretreated HIV-infected
children in response to salvage therapy with LPV/r as a consequence
of a decrease in immune system activation and an increase in thymic
function.”
Laboratorio de Inmuno-Biologia Molecular, Hospital General
Universitario "Gregorio Maranon", Madrid, Spain.
06/08/05
Reference
S
Resino and others. Immunological Changes after Highly Active Antiretroviral
Therapy with Lopinavir-Ritonavir in Heavily Pretreated HIV-Infected
Children. AIDS Research and Human Retroviruses 21(5):
398-406. May 2005.
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