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. 2003 Sep;10(5):821-5.
doi: 10.1128/cdli.10.5.821-825.2003.

Immunity to human immunodeficiency virus (HIV) in children with chronic HIV infection receiving highly active antiretroviral therapy

Adriana Weinberg  1 , Gregory B Pott
Affiliations

Immunity to human immunodeficiency virus (HIV) in children with chronic HIV infection receiving highly active antiretroviral therapy

Adriana Weinberg et al. Clin Diagn Lab Immunol. 2003 Sep.

Abstract

Our objective was to describe the CD4-mediated human immunodeficiency virus (HIV)-specific cell-mediated immunity (CMI) and its virologic and immunologic correlates in children with chronic HIV infection on highly active antiretroviral therapy (HAART). Twelve HIV-infected children on stable antiretroviral therapy with a median level of CD4+ lymphocytes (CD4%) of 25.5% and a median viral load (VL) of 786 HIV RNA copies/ml were enrolled in this study. Nine of these children were also cytomegalovirus (CMV) seropositive. Blood mononuclear cells, stimulated with HIV and CMV antigens, were used to measure lymphocyte proliferation and to enumerate gamma interferon (IFN-gamma)-producing CD4+ cells. HIV CMI and CMV CMI were detected in similar proportions of patients and correlated with each other, although the HIV responses were less robust. HIV lymphocyte proliferation significantly increased with lower HIV VL and showed a trend to increase with higher CD4% and longer time on HAART. The in vitro IFN-gamma response to HIV or CMV was not affected by CD4%, VL, or HAART. Pediatric patients with established HIV infection on HAART frequently exhibit HIV CMI despite undetectable HIV replication. We concluded that the association between HIV CMI and CMV CMI indicates that the same factors govern responsiveness to either antigen.

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Figures

FIG. 1.
FIG. 1.
HIV- and CMV-specific CMI in HIV- infected children on HAART. Data represent results of assays performed with PBMC from 12 HIV-seropositive pediatric patients, 9 of whom were also CMV seropositive. Results for each patient contributed 2 to 6 data points. Dotted lines indicate thresholds for positive results. Solid lines indicate medians. (A) HIV LPA responses were significantly lower than those for CMV with respect to proportion of positive results (P = 0.02) and amplitude of response (P = 0.006). (B) The difference in the proportions of positive ELISPOT assay results for HIV and CMV did not reach statistical significance (P = 0.06), but the magnitude of the response was significantly lower for HIV than for CMV (P = 0.007).(C) ICCK responses were similar for HIV- and CMV-seropositive patients with respect to proportion of positive results (P = 0.16) and magnitude of the response (P = 0.3).
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