Guillen, SaraPrieto, LuisJimenez de Ory, SantiagoGonzalez-Tome, Maria IsabelRojo, PabloNavarro, Maria LuisaMellado, Maria JoséEscosa, LuisSainz, TaliaFrancisco, LauraMuñoz-Fernandez, Maria AngelesRamos, José TomásGarcia Hortelano, MilagrosBlazquez, DanielEpalza, CristinaSaavedra, JesusSantos, MarMuñoz, María AngelesSantiago, BegoñaCarrasco, ItziarRoa, Miguel AngelBeceiro, JosePenin, MariaMartinez, JorgeBadillo, KatieApilanez, MirenPocheville, ItziarGarrote, ElisaColino, ElenaGomez Sirvent, JorgeGarzon, MonicaRoman, VicenteMuñoz, Maria JoseAngulo, RaquelNeth, OlafFalcon, LolaTerol, PedroSantos, Juan LuisMoreno, DavidLendinez, FranciscoPeromingo, EstrellaMontero, MariaGrande, AnaRomero, Francisco JosePerez, CarlosMartinez, MariaLillo, MiguelLosada, BegonaHerranz, MercedesBustillo, MatildeGuerrero, CarmeloCollado, PilarCouceiro, Jose AntonioVila, LeticiaCalvino, ConsueloPiqueras, Ana IsabelBreton, RafaelOltra, ManuelLopez, EvaSegarra, InmaculadaGavilan, CesarMontesinos, ElenaDapena, MartaÁlvarez Segurado, CristinaJimenez, BeatrizGloria Andres, AnaMarugan, VictorOchoa, CarlosAlfayate, SantiagoMenasalvas, Ana IsabelRuiz del Prado, YolandaSoler-Palacín, PereAntoinette Frick, MariaMur, AntonioLopez, NuriaMendez, MariaMayol, LluisVallmanya, TeresaCalavia, OlgaGarcia, LourdesPineda, ValentiRius, NeusDueñas Morales, JoaquinFortuny, ClaudiaNoguera-Julian, AntoniCoRISpe (Cohorte Nacional de VIH pediátrica de la RED RIS)2024-09-102024-09-102019-08-05Guillen 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):e0220552.1932-6203http://hdl.handle.net/20.500.13003/15453https://hdl.handle.net/20.500.12105/22796Background: 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).enghttp://creativecommons.org/licenses/by/4.0/ChildViral LoadAnti-Retroviral AgentsHumansImmunityAntiretroviral Therapy, Highly ActiveChild, PreschoolAdolescentInfantPrognosisHIV InfectionsMaleInfant, NewbornCD4-CD8 RatioFemaleHIV-1research articleAttribution 4.0 International31381604148e022055210.1371/journal.pone.0220552PloS Oneopen accessVIH-1AntirretroviralesRecién NacidoRelación CD4-CD8FemeninoInfecciones por VIHLactanteAdolescenteTerapia Antirretroviral Altamente ActivaMasculinoInmunidadPreescolarHumanosPronósticoNiñoCarga Viral2-s2.0-85070370387484993600024L2002524887