Viral Load and CD4⁺ T Lymphocyte Response to Highly Active Antiretroviral Therapy in Human Immunodeficiency Virus Type 1-Infected Children: An Observational Study

An observational study was performed involving 95 children with vertically transmitted human immunodeficiency virus type 1 infection to assess the sustainability of undetectable viral loads (VLs) and increased CD4⁺ T lymphocyte percentages after 48 months of highly active antiretroviral therapy (HAART). The median time to achieve a 10% increase in the CD4⁺ T lymphocyte percentage was 11.01 months. The median time to achieve an undetectable VL was 6.4 months. At the end of the study, 64.2% of the children had achieved an undetectable VL. Of the patients with an initial VL of >3.6 log₁₀ copies/mL, 74.7% had a decrease in the VL of 1 log₁₀ copies/mL. By contrast, of the patients who presented with an initial VL of >4.6 log₁₀ copies/mL, 37.9% had a decrease of >2 log₁₀ copies/mL. Higher VL at baseline, antiretroviral therapy regimens received before HAART, and multiple drug switches while receiving antiretroviral therapy were all inversely associated with an undetectable VL. A CD4⁺ T lymphocyte percentage of >25% was directly associated with undetectable VL during the follow-up period. In conclusion, first-line HAART induces beneficial virological and immunological outcome responses in children.