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oai:repisalud.isciii.es:20.500.12105/227962025-05-08T15:27:05Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16967

00925njm 22002777a 4500 dc Guillen, Sara author Prieto, Luis author Jimenez de Ory, Santiago author Gonzalez-Tome, Maria Isabel author Rojo, Pablo author Navarro, Maria Luisa author Mellado, Maria José author Escosa, Luis author Sainz, Talia author Francisco, Laura author Muñoz-Fernandez, Maria Angeles author Ramos, José Tomás author Garcia Hortelano, Milagros author Blazquez, Daniel author Epalza, Cristina author Saavedra, Jesus author Santos, Mar author Muñoz, María Angeles author Santiago, Begoña author Carrasco, Itziar author Roa, Miguel Angel author Beceiro, Jose author Penin, Maria author Martinez, Jorge author Badillo, Katie author Apilanez, Miren author Pocheville, Itziar author Garrote, Elisa author Colino, Elena author Gomez Sirvent, Jorge author Garzon, Monica author Roman, Vicente author Muñoz, Maria Jose author Angulo, Raquel author Neth, Olaf author Falcon, Lola author Terol, Pedro author Santos, Juan Luis author Moreno, David author Lendinez, Francisco author Peromingo, Estrella author Montero, Maria author Grande, Ana author Romero, Francisco Jose author Perez, Carlos author Martinez, Maria author Lillo, Miguel author Losada, Begona author Herranz, Mercedes author Bustillo, Matilde author Guerrero, Carmelo author Collado, Pilar author Couceiro, Jose Antonio author Vila, Leticia author Calvino, Consuelo author Piqueras, Ana Isabel author Breton, Rafael author Oltra, Manuel author Lopez, Eva author Segarra, Inmaculada author Gavilan, Cesar author Montesinos, Elena author Dapena, Marta author Álvarez Segurado, Cristina author Jimenez, Beatriz author Gloria Andres, Ana author Marugan, Victor author Ochoa, Carlos author Alfayate, Santiago author Menasalvas, Ana Isabel author Ruiz del Prado, Yolanda author Soler-Palacín, Pere author Antoinette Frick, Maria author Mur, Antonio author Lopez, Nuria author Mendez, Maria author Mayol, Lluis author Vallmanya, Teresa author Calavia, Olga author Garcia, Lourdes author Pineda, Valenti author Rius, Neus author Dueñas Morales, Joaquin author Fortuny, Claudia author Noguera-Julian, Antoni author CoRISpe (Cohorte Nacional de VIH pediátrica de la RED RIS) author 2019-08-05 Background: 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). Guillen S, Prieto L, Jimenez De Ory S, Gonzalez-Tome MI, Rojo P, Navarro ML, et al. Prognostic factors of a lower CD4/CD8 ratio in long term viral suppression HIV infected children. PLoS One. 2019 Aug 05;14(8):e0220552. 10.1371/journal.pone.0220552 1932-6203 PloS One http://hdl.handle.net/20.500.13003/15453 31381604 L2002524887 2-s2.0-85070370387 https://hdl.handle.net/20.500.12105/22796 484993600024 Prognostic factors of a lower CD4/CD8 ratio in long term viral suppression HIV infected children