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July 13, 2006
HIV Reservoir Decays Slowly In Children (Reuters Health)
Thursday July 13, 2006 (Reuters Health) - Although there is a rapid drop in HIV levels in infected children after initial highly active antiretroviral therapy (HAART), further decay is less rapid, according to Italian and UK researchers.
As senior investigator Dr. Anita De Rossi told Reuters Health, "Our results demonstrated that the clearance of viral reservoir in children depends on CD4 immune reconstitution and residual viral replication, and occurs more slowly than previously estimated in adults."
In the June 15th issue of the Journal of Infectious Diseases, Dr. De Rossi of the University of Padua and colleagues report their study of peripheral blood samples from 14 HIV-infected children who had achieved and maintained suppression of plasma viremia for up to 48 months after HAART initiation.
During the first month of HAART, there was a significant decay in levels of plasma HIV-1 RNA and multiply spliced HIV-1 RNA. Unspliced HIV-1 RNA persisted in most children.
There was a correlation between greater HIV-1 DNA decay during this period and a higher concomitant increase in CD4+ cell counts and a smaller subsequent decay in HIV-1 DNA.
Moreover, the median half-life of HIV-1 DNA was 5 months during the first 9 months of HAART, but rose to a median of 30 months in subsequent follow-up.
In addition, the researchers found that after 9 months of HAART, levels of HIV-1 DNA tended to decay more slowly in children with detectable levels of unspliced HIV-1 RNA.
The researchers conclude that "eradication of HIV-1 infection is not feasible in chronically infected children." These findings, added Dr. De Rossi, "are quite important for planning long-term treatment strategies."
