000098373 001__ 98373
000098373 005__ 20210318091535.0
000098373 0247_ $$2doi$$a10.1371/journal.pone.0220552
000098373 0248_ $$2sideral$$a122125
000098373 037__ $$aART-2019-122125
000098373 041__ $$aeng
000098373 100__ $$aGuillen, S.
000098373 245__ $$aPrognostic factors of a lower CD4/CD8 ratio in long term viral suppression HIV infected children
000098373 260__ $$c2019
000098373 5060_ $$aAccess copy available to the general public$$fUnrestricted
000098373 5203_ $$aBackground
Combination antiretroviral therapy (cART) is associated with marked immune reconstitution. Although a long term viral suppression is achievable, not all children however, attain complete immunological recovery due to persistent immune activation. We use CD4/CD8 ratio like a marker of immune reconstitution.
Methods
Perinatal HIV-infected children who underwent a first-line cART, achieved viral suppression in the first year and maintained it for more than 5 years, with no viral rebound were included. Logistic models were applied to estimate the prognostic factors, clinical characteristics at cART start, of a lower CD4/CD8 ratio at the last visit.
Results
146 HIV-infected children were included: 77% Caucasian, 45% male and 28% CDC C. Median age at cART initiation was 2.3 years (IQR: 0.5-6.2). 42 (30%) children received mono-dual therapy previously to cART. Time of undetectable viral load was 9.5 years (IQR: 7.8, 12.5). 33% of the children not achieved CD4/CD8 ratio >1. Univariate analysis showed an association between CD4/CD8 <1 with lower CD4 nadir and baseline CD4; older age at diagnosis and at cART initiation; and a previous exposure to mono-dual therapy. Multivariate analysis also revealed relationship between CD4/CD8 <1 and lower CD4 nadir (OR: 1.002, CI 95% 1.000-1.004) as well as previous exposure to mono-dual therapy (OR: 0.16, CI 95% 0.003-0.720).
Conclusions
CD4/CD8 > 1 was not achieved in 33% of the children. Lower CD4 nadir and previous exposure to suboptimal therapy, before initiating cART, are factors showing independently association with a worse immune recovery (CD4/CD8 < 1).
000098373 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000098373 590__ $$a2.74$$b2019
000098373 591__ $$aMULTIDISCIPLINARY SCIENCES$$b27 / 71 = 0.38$$c2019$$dQ2$$eT2
000098373 592__ $$a1.023$$b2019
000098373 593__ $$aMultidisciplinary$$c2019$$dQ1
000098373 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000098373 700__ $$aPrieto, L.
000098373 700__ $$ade Ory, S.J.
000098373 700__ $$aGonzalez-Tome, M.I.
000098373 700__ $$aRojo, P.
000098373 700__ $$aNavarro, M.L.
000098373 700__ $$aMellado, M.J.
000098373 700__ $$aEscosa, L.
000098373 700__ $$aSainz, T.
000098373 700__ $$aFrancisco, L.
000098373 700__ $$aMunoz-Fernandez, M.A.
000098373 700__ $$aRamos, J.T.
000098373 700__ $$aHortelano, M.G.
000098373 700__ $$aBlazquez, D.
000098373 700__ $$aEpalza, C.
000098373 700__ $$aSaavedra, J.
000098373 700__ $$aSantos, M.
000098373 700__ $$aMunoz, M.A.
000098373 700__ $$aSantiago, B.
000098373 700__ $$aCarrasco, I.
000098373 700__ $$aRoa, M.A.
000098373 700__ $$aBeceiro, J.
000098373 700__ $$aPenin, M.
000098373 700__ $$aMartinez, J.
000098373 700__ $$aBadillo, K.
000098373 700__ $$aApilanez, M.
000098373 700__ $$aPocheville, I.
000098373 700__ $$aGarrote, E.
000098373 700__ $$aColino, E.
000098373 700__ $$aSirvent, J.G.
000098373 700__ $$aGarzon, M.
000098373 700__ $$aRoman, V.
000098373 700__ $$aMunoz, M.J.
000098373 700__ $$aAngulo, R.
000098373 700__ $$aNeth, O.
000098373 700__ $$aFalcon, L.
000098373 700__ $$aTerol, P.
000098373 700__ $$aSantos, J.L.
000098373 700__ $$aMoreno, D.
000098373 700__ $$aLendinez, F.
000098373 700__ $$aPeromingo, E.
000098373 700__ $$aMontero, M.
000098373 700__ $$aGrande, A.
000098373 700__ $$aRomero, F.J.
000098373 700__ $$aPerez, C.
000098373 700__ $$aMartinez, M.
000098373 700__ $$aLillo, M.
000098373 700__ $$aLosada, B.
000098373 700__ $$aHerranz, M.
000098373 700__ $$aBustillo, M.
000098373 700__ $$aGuerrero, C.
000098373 700__ $$0(orcid)0000-0001-8346-0544$$aCollado, P.$$uUniversidad de Zaragoza
000098373 700__ $$aCouceiro, J.A.
000098373 700__ $$aVila, L.
000098373 700__ $$aCalvino, C.
000098373 700__ $$aPiqueras, A.I.
000098373 700__ $$aBreton, R.
000098373 700__ $$aOltra, M.
000098373 700__ $$aLopez, E.
000098373 700__ $$aSegarra, I.
000098373 700__ $$aGavilan, C.
000098373 700__ $$aMontesinos, E.
000098373 700__ $$aDapena, M.
000098373 700__ $$aAlvarez, C.
000098373 700__ $$aJimenez, B.
000098373 700__ $$aAndres, A.G.
000098373 700__ $$aMarugan, V.
000098373 700__ $$aOchoa, C.
000098373 700__ $$aAlfayate, S.
000098373 700__ $$aMenasalvas, A.I.
000098373 700__ $$adel Prado, Y.R.
000098373 700__ $$aSoler-Palacin, P.
000098373 700__ $$aFrick, M.A.
000098373 700__ $$aMur, A.
000098373 700__ $$aLopez, N.
000098373 700__ $$aMendez, M.
000098373 700__ $$aMayol, L.
000098373 700__ $$aVallmanya, T.
000098373 700__ $$aCalavia, O.
000098373 700__ $$aGarcia, L.
000098373 700__ $$aPineda, V.
000098373 700__ $$aRius, N.
000098373 700__ $$aDuenas, J.
000098373 700__ $$aFortuny, C.
000098373 700__ $$aNoguera-Julian, A.
000098373 7102_ $$11010$$2670$$aUniversidad de Zaragoza$$bDpto. Pediatría Radiol.Med.Fís$$cÁrea Pediatría
000098373 773__ $$g14, 8 (2019), e0220552[11 pp]$$pPLoS One$$tPloS one$$x1932-6203
000098373 8564_ $$s428054$$uhttps://zaguan.unizar.es/record/98373/files/texto_completo.pdf$$yVersión publicada
000098373 8564_ $$s2080406$$uhttps://zaguan.unizar.es/record/98373/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000098373 909CO $$ooai:zaguan.unizar.es:98373$$particulos$$pdriver
000098373 951__ $$a2021-03-18-09:10:24
000098373 980__ $$aARTICLE