[pronut-hiv] Even Partial Viral Response to HAART Helps HIV-Positive Children

["Pronut-hiv" <healthnet.org>]

Even Partial Viral Response to HAART Helps HIV-Positive Children

By David Douglas

NEW YORK (Reuters Health) Jul 21 - Use of highly active antiretroviral therapy (HAART) can lead to immunological benefit, even in highly treatment-experienced children who only have a partial viral load response, investigators report in the July 15th issue of Clinical Infectious Diseases.

Thus, lead researcher Dr. Andrea Kovacs told Reuters Health, "a child can be on a regimen that they can tolerate but that achieves less than the optimally recommended declines... and achieve CD4 response as good as if they had undetectable RNA. Even with rebound, CD4 counts can be maintained above baseline for up to 32 weeks."

Dr. Kovacs of the University of Southern California Keck School of Medicine, Los Angeles, and colleagues came to this conclusion after assessing CD4 cell recovery in 175 children with advanced HIV disease who were given a 4-drug HAART regimen. They were classified as being viral load responders, partial responders or non-responders.

The researchers note that there were "striking increases in CD4 cell counts for up to 2 years." This was true in complete responders as well as in partial responders, despite their having HIV RNA levels above 400 copies per mL. Even children with viral load rebound had immunological benefits for 6 months or more.

It appears, Dr. Kovacs continued, "that immune responses are greater than reported for adults. Even those who had no response appeared to have stabilization of their T cells."

Therefore, she concluded, "definition of success may need to be reassessed for children, since immune success occurs even with partial viral response."

J Infect Dis 2005;192:296-302.