Treatment Causes Immune Cell Rebound in Children with HIV

Vast majority of children with HIV experience recovery of immune system following therapy.

The majority of children with low levels of vital immune cells due to HIV infection can experience a recovery of the cells after the start of treatment, a recent study indicates.

HIV has a significant impact on CD4+ t cells, which don’t rebound after medication suppresses the virus in approximately 15% of adult patients and is linked with life-threatening conditions.

"We were pleased to find that the vast majority of children experience immune system recovery with effective therapy," study first author Paul Krogstad, MD, said in a press release. "Our study also provided the most detailed information to date about the timing of this recovery in school-age children."

The study, published online in the journal AIDS, sought to evaluate how children infected with HIV near the time of birth carry a risk of diminished CD4+ t cells and if this is associated with a major risk of serious infection.

A small proportion of young children infected with HIV experience a failure in the recovery of CD4+ t cells.

"The comparatively few children whose CD4+ cells failed to rebound did not appear to be at any greater risk for serious infection than children with higher CD4+ counts," said study co-author Rohan Hazra, MD, in a press release.

The researchers noted the results of the study will most likely not alter treatment recommendations for children with HIV, which utilizes antiretroviral treatment to suppress the virus with follow up examinations to detect signs of serious infections.

The researchers evaluated more than 3700 children in the US, Central America, South America, and the Caribbean infected with HIV before or during birth. The study also tracked CD4+ cell counts of 933 children who were at least 5 years of age when they began treatment.

A healthy CD4+ cell count falls within 500 to 1200 cells per blood sample, with less than 500 cells per sample deemed low, and 200 cells or less per sample deemed very low. Following a year of treatment for HIV, 86% of the children had CD4+ counts of 500 or more, while 92% of patients surpassed 500 or more 2 years after the start of treatment.

Nine of the children experienced CDC Category C events, which indicate a weakened immune system in people with AIDS. In a comparison of adults with low CD4+ counts at the beginning of treatment, CD4+ counts in children jump above 500 over time following the start of therapy.

Despite these increases, some children experienced Category C conditions or other significant illnesses over the first 3 years of treatment.

The study concluded additional research is necessary to evaluate the increased illness risk.