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Thymic output and CD4 T-cell reconstitution in HIV-infected children on early and interrupted antiretroviral treatment : evidence from the children with HIV early antiretroviral therapy trial

dc.contributor.authorLewis, Joannaen_ZA
dc.contributor.authorPayne, Helenen_ZA
dc.contributor.authorWalker, A. Sarahen_ZA
dc.contributor.authorOtwombe, Kennedyen_ZA
dc.contributor.authorGibb, Diana M.en_ZA
dc.contributor.authorBabiker, Abdel G.en_ZA
dc.contributor.authorPanchia, Ravindreen_ZA
dc.contributor.authorCotton, Mark. F.en_ZA
dc.contributor.authorViolari, Avyen_ZA
dc.contributor.authorKlein, Nigelen_ZA
dc.contributor.authorCallard, Robin E.en_ZA
dc.date.accessioned2018-10-10T10:20:50Z
dc.date.available2018-10-10T10:20:50Z
dc.date.issued2017-09
dc.identifier.citationLewis, J. 2017. Thymic output and CD4 T-cell reconstitution in HIV-infected children on early and interrupted antiretroviral treatment : evidence from the children with HIV early antiretroviral therapy trial. Frontiers in Immunology, 8:1162, doi:10.3389/fimmu.2017.01162.
dc.identifier.otherdoi:10.3389/fimmu.2017.01162
dc.identifier.urihttp://hdl.handle.net/10019.1/104553
dc.descriptionCITATION: Lewis, J. 2017. Thymic output and CD4 T-cell reconstitution in HIV-infected children on early and interrupted antiretroviral treatment : evidence from the children with HIV early antiretroviral therapy trial. Frontiers in Immunology, 8:1162, doi:10.3389/fimmu.2017.01162.
dc.descriptionThe original publication is available at https://www.frontiersin.org/journals/immunology
dc.description.abstractObjectives: Early treatment of HIV-infected children and adults is important for optimal immune reconstitution. Infants’ immune systems are more plastic and dynamic than older children’s or adults’, and deserve particular attention. This study aimed to understand the response of the HIV-infected infant immune system to early antiretroviral therapy (ART) and planned ART interruption and restart. Methods: Data from HIV-infected children enrolled the CHER trial, starting ART aged between 6 and 12 weeks, were used to explore the effect of ART on immune reconstitution. We used linear and non-linear regression and mixed-effects models to describe children’s CD4 trajectories and to identify predictors of CD4 count during early and interrupted ART. Results: Early treatment arrested the decline in CD4 count but did not fully restore it to the levels observed in HIV-uninfected children. Treatment interruption at 40 or 96 weeks resulted in a rapid decline in CD4 T-cells, which on retreatment returned to levels observed before interruption. Naïve CD4 T-cell count was an important determinant of overall CD4 levels. A strong correlation was observed between thymic output and the stable CD4 count both before and after treatment interruption. Conclusion: Early identification and treatment of HIV-infected infants is important to stabilize CD4 counts at the highest levels possible. Once stabilized, children’s CD4 counts appear resilient, with good potential for recovery following treatment interruption. The naïve T-cell pool and thymic production of naive cells are key determinants of children’s CD4 levels.en_ZA
dc.description.urihttps://www.frontiersin.org/articles/10.3389/fimmu.2017.01162/full
dc.format.extent11 pages
dc.language.isoen_ZAen_ZA
dc.publisherFrontiers
dc.subjectAntiretroviral therapyen_ZA
dc.subjectHIV infectionsen_ZA
dc.subjectHIV-positive childrenen_ZA
dc.subjectAntiretroviral agentsen_ZA
dc.titleThymic output and CD4 T-cell reconstitution in HIV-infected children on early and interrupted antiretroviral treatment : evidence from the children with HIV early antiretroviral therapy trialen_ZA
dc.typeArticleen_ZA
dc.description.versionPublisher's version
dc.rights.holderAuthors retain copyright


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