Immunoreconstitution after ritonavir therapy in children with human immunodeficiency virus infection involves multiple lymphocyte lineages.
Immunoreconstitution after ritonavir therapy in children with human immunodeficiency virus infection involves multiple lymphocyte lineages.
复制标题
人类免疫缺陷病毒感染儿童利托那韦治疗后的免疫重建涉及多种淋巴细胞谱系。
DOI：
10.1016/s0022-3476(99)70247-7
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
Mueller,BU
中科院分区：
文献类型：
--
作者：
Sleasman,JW;Nelson,RP;Goodenow,MM;Wilfret,D;Hutson,A;Baseler,M;Zuckerman,J;Pizzo,PA;Mueller,BU
目的评价人类免疫缺陷病毒(HIV)感染儿童在接受蛋白酶抑制剂治疗后的淋巴细胞重建情况。研究设计在一项I/II期临床试验中，44名HIV感染儿童先接受利托那韦治疗，然后加用齐多夫定和地达诺辛。年龄中位数为6.8岁，疾病晚期(57%为疾病预防控制中心C期，73%为免疫期3)，且对蛋白水解酶抑制剂治疗天真。结果治疗4周后，CD4+和CD8+T细胞显著增加。CD4+T细胞持续增加，而CD8+T细胞在24周时恢复到基线水平。出乎意料的是，B细胞显著增加。CD_4~+T细胞亚群的变化显示，CD_4~+CD45RO T细胞最初增加，随后CD_4~+CD45RA T细胞持续增加。在所有淋巴细胞群体中，6岁儿童的增幅最高。结论利托那韦治疗后早期淋巴细胞升高是再循环的结果，表现为B细胞、CD4+CD45RO和CD8+T细胞的升高。儿童表现出很高的重建CD4+CD45RA T细胞的潜力，即使在疾病晚期和病毒抑制不完全的情况下也是如此。(儿科杂志1999；134：597-606)
ObjectiveTo evaluate lymphocyte reconstitution after protease inhibitor therapy in children with human immunodeficiency virus (HIV) infection.Study designForty-four HIV-infected children receiving ritonavir monotherapy followed by the addition of zidovudine and didanosine were evaluated during a phase I/II clinical trial. The cohort had a median age of 6.8 years and advanced disease (57% Centers for Disease Control and Prevention stage C, 73% immune stage 3) and was naive to protease inhibitor therapy.ResultsAfter 4 weeks of therapy, there was a significant increase in CD4+and CD8+T cells. CD4+T cells continued to increase, whereas CD8+T cells returned to baseline by 24 weeks. Unexpectedly, there was a significant increase in B cells. Changes in CD4+T-cell subsets revealed an initial increase in CD4+CD45RO T cells followed by a sustained increase in CD4+CD45RA T cells. Children <6 years of age had the highest increase in all lymphocyte populations. Significant improvement in CD4+T-cell counts was observed even in those children whose viral burden returned to pre-therapy levels.ConclusionsEarly increases in lymphocytes after ritonavir therapy are a result of recirculation, as shown by increases in B cells and CD4+CD45RO and CD8+T cells. Children exhibited a high potential to reconstitute CD4+CD45RA T cells even with advanced disease and incomplete viral suppression. (J Pediatr 1999;134:597-606)