ANTIRETROVIRAL THERAPY, VIRAL LOAD, AND T LYMPHOCYTES RATE IN HIV-1 INFECTED CHILDREN AFTER GENOTYPING DRUG RESISTANCE ASSESSMENT

Studies related to Human Immunodeficiency Virus type 1-infected children are of a special meaning due to multiple covariates such as timing of transmission, viral phenotypes, immunological patterns, viral dynamics progression and clinical evolution of disease. With antiretroviral therapy becoming more widely available, HIV resistance identification and monitoring of disease remains of great importance in infected children. The major HIV-1 infection markers usually used for monitoring viral infection and disease course are CD4+ T cell counts or percentages and HIV viral load. Both of them are helpful indicating when to start therapy and evaluating its efficacy. Also, their association with genotyping tests identifying viral resistant mutations may help clinicians for the most adequate clinical conduct. In the present study, we assessed HIV-1 viral load and CD4+ and CD8+ T lymphocyte rates for the immunological status evaluation of 25 antiretroviral-treated children or at the beginning of therapy, managing therapeutic regimens according to genotyping results. The management of highly active antiretroviral therapy (HAART) according to viral resistance in our group of pediatric patients allowed an increase in CD4+ T cell counts and/or percentage in almost all children, showing an improvement in their HIV-associated immunodeficiency status. Important viral burden declines were observed in 24 children, most of them multi-drug resistant, with HIV RNA undetectable levels reached in 12 of them. In particular, HAART introduction allowed a more significant viral load reduction for those pediatric patients who were drug treatment-naive, initiating antiretroviral therapy as they were enrolled at this study. DOI: http://dx.doi.org/10.17525/vrr.v14i1.23