Natural history of HIV infected pediatric long-term or slow progressor population after the first decade of life.
Natural history of HIV infected pediatric long-term or slow progressor population after the first decade of life.
复制标题
生命第一个十年后感染艾滋病毒的儿童长期或缓慢进展人群的自然史。
DOI：
10.1097/01.inf.0000254413.11246.e1
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发表时间：
2007
期刊：
影响因子：
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通讯作者：
Borkowsky,William
中科院分区：
文献类型：
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作者：
Ofori-Mante,JulianaA;Kaul,Aditya;Rigaud,Mona;Fidelia,Andre;Rochford,Gemma;Krasinski,Keith;Chandwani,Sulachni;Borkowsky,William
背景：围产期感染的长期无进展者/缓慢进展者代表了一组精选的个体。关于这群10岁以上儿童的信息非常有限。对一组hiv感染的长期无进展/缓慢进展儿童进行了研究。方法：我们招募了20名感染艾滋病毒的青少年，他们在10岁之前没有接受或很少接受治疗（定义为单核苷或双核苷治疗），并且在生命的头十年中CD4计数保持在25%以上。我们分析了免疫和病毒学特征。胸腺受体切除圈（TREC）测定储存的冷冻外周血单核细胞。CD4计数，病毒载量和其他相关信息，包括种族和年龄，从个人医疗记录中获得。结果：招募的20名患者中有9名在青春期前后CD4计数下降，而其他11名保持稳定。两组患者青春期前后TREC值和HIV RNA值均无差异。那些保持稳定的人，就维持CD4 T细胞而言，随着年龄的增长，病毒载量下降。那些CD4值在青春期后下降的人的病毒载量并没有随着年龄的增长而下降。结论：一组在生命的头十年中从未接受过HAART治疗的患者将继续保持良好的CD4与HIV RNA值下降相关。胸腺输出不能预测那些不维持CD4 T细胞的人。
Background:Perinatally infected long-term nonprogressors/slow progressors represent a select group of individuals. There is very limited information on this group of children beyond the first decade of life. A group of HIV-infected long-term nonprogressor/slow progressor children was studied.Methods:We enrolled 20 HIV-infected adolescents who were receiving no or minimal therapy (defined as single or dual nucleoside therapy) before the age of 10 years and who had maintained CD4 counts above 25% for the first decade of life. We analyzed immunologic and virologic characteristics. Thymic receptor excision circles (TREC) were measured on stored frozen peripheral blood mononuclear cells. CD4 count, viral load and other pertinent information including race and age were obtained from individual medical records.Results:Nine of the 20 patients recruited were noted to have developed falling CD4 counts at or around puberty, whereas the other 11 remained stable. There was no difference in TREC values or HIV RNA values before or after puberty between the 2 groups of patients. Those who remained stable, in terms of maintaining CD4 T cells as a group had falling viral loads with age. Those whose CD4 values declined after puberty had viral loads that did not decrease with age.Conclusion:A select group of patients who never received HAART during their first decade of life will continue to maintain good CD4 associated with declining HIV RNA values. Thymic output is not predictive of those that don’t maintain CD4 T cells.