Early highly active antiretroviral therapy enhances B-cell longevity: a 5 year follow up

Pediatr Infect Dis J. 2014 May;33(5):e126-31. doi: 10.1097/INF.0000000000000144.

Abstract

Background: We have previously reported that an early initiation of highly active antiretroviral therapy (HAART) in HIV-1 vertically infected children enhanced the function of memory B-cells gained during childhood routine vaccinations. On the other hand, a significant waning of immunity was observed for patients with a late treatment. In this follow-up study, we report data from a sample of patients in our cohort including late-treated patients being revaccinated with routine childhood vaccines.

Methods: The levels of serum antibodies and cellular immunity were measured by antigen-specific enzyme-linked immunosorbent assay and B-cell ELISpot. Moreover, flow cytometry on the frequencies of mature-activated (CD10-CD21-) and double-negative (CD27-IgD-) B-cells as hallmarks of immune activation and immune senescence, respectively, was performed for all patients.

Results: Reduced protective humoral immunity and cellular immunity to routine childhood vaccines was observed in late-treated patients. Moreover, we found that timing of HAART related with the frequencies of mature activated and double negative.

Conclusions: Altogether the data presented in this follow-up study reenforce the importance for an early start of HAART in HIV-1 vertically infected individuals and suggest that timing of HAART is a fundamental factor to take into account for vaccination design in this population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anti-Retroviral Agents / administration & dosage*
  • Antibodies / blood
  • Antiretroviral Therapy, Highly Active / methods*
  • B-Lymphocytes / immunology*
  • B-Lymphocytes / physiology
  • Cell Survival
  • Child
  • Enzyme-Linked Immunosorbent Assay
  • Enzyme-Linked Immunospot Assay
  • Female
  • Flow Cytometry
  • Follow-Up Studies
  • HIV Infections / drug therapy*
  • HIV Infections / immunology*
  • Humans
  • Male
  • Time Factors
  • Vaccines / administration & dosage
  • Vaccines / immunology*
  • Young Adult

Substances

  • Anti-Retroviral Agents
  • Antibodies
  • Vaccines