PACTG 1006: EFFECTS OF HAART ON THE RECOVERY OF IMMUNE FUNCTION IN HIV+ CHILDREN

这个子项目是众多研究子项目之一

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This study is a randomized, comparative response study with long-term follow-up in HIV-infected children aged 2-17 years who are severely immunocompromised and are initiating highly active antiretroviral therapy (HAART). Subjects must be virologic responders, defined as >0.75 log decrease in plasma HIV RNA copy number 1 month after initiation of HAART. It will consist of approximately 90 subjects in two groups. The purpose of this study is to assess the ability of newly derived CD4 T cells to spontaneously develop lymphoproliferative responses to a recall antigen, tetanus toxoid, or to develop responses after booster vaccinations with tetanus vaccine; to assess the ability to develop protective antibody responses to a T cell-dependent antigen using a primary series of hepatitis A vaccinations.; and to measure the durability of any response beyond the last vaccination. The rationale for this study is that HIV-infected children initiating HAART have shown significant inhibition of HIV growth and significant increases in CD4 T cell counts. It is not known to what extent an increase in CD4 count in this population of children translates to a complete functional immune recovery. HIV-infected children have typically demonstrated poor serological responses to routine childhood immunizations. This study will examine the phenotype of T cells regenerated post-HAART initiation and will assess function by evaluating T cell responses to neoantigens and recall antigens. Cell-mediated immune responses to an environmental antigen (Candida), a recall antigen (tetanus), and a primary immunogen (hepatitis A) will be tested. Studies of immunologic function and recovery will be assessed and correlated with CD4 cells, HAART treatment, and duration of response.