Non-expensive and low-complexity surrogate markers for monitoring the response to combined antiretroviral therapy (combined-ART) are needed in poor-resource settings where routine assessment of CD4+ T-lymphocyte count and viral load can not be afforded. We longitudinally evaluated Ig serum levels in 234 HIV-1 infected children receiving combined-ART with >= 3 drugs. Since Ig levels physiologically vary with age, differences at different age periods were evaluated as differences in z-scores calculated using the mean and standard deviation of the normal population for each age period. Data from 17 (7.3%) children with immunological failure and from 54 (23.1%) children with virological failure of combined-ART were compared with data from not-failed children. At baseline children with immunological failure showed higher IgM z-scores (P = 0.042) than children without. After 3-12 months of therapy immunologically failed children displayed higher viral loads (P < 0.0001) and IgA (P = 0.043) z-scores than not-failed children. Similarly, at the same follow-up time, children with virological failure showed lower CD4(+) T-lymphocyte percentages (P = 0.005) and higher IgA z-scores (P < 0.0001) than not-failed children. No difference in IgG or IgM z-scores was evidenced between failed and not-failed children after 3-12 months of therapy. In conclusion, IgA serum level is a cheap and low-complexity marker of immunological or virological failure of combined-ART which might be adopted in poor-resource settings.
|Autori:||The Italian Register for HIV Infection in Children. Writing committee: E. Chiappini; L. Galli; PA. Tovo; C. Gabiano; M. de Martino. Partecipants: P. Osimani; R. Cordiali; D. De Mattia; M. Manzionna; C. Di Bari; M. Ruggeri; M. Masi; A. Miniaci; F. Specchia; M. Ciccia; M. Lanari; F. Baldi; L. Battisti; R. Badolato; M. Duse; C. Fiorino; C. Dessì; C. Pintor; M. Dedoni; ML Fenu; R. Cavallini; E. Anastasio; F. Merolla; M. Sticca; G. Pomero; T. Bezzi; E. Fiumana; S. Collini; A. Placido; P. Vitucci; MT. Cecchi; D. Cosso; A. Timitilli; M. Stronati; A. Plebani; R. Pinzani; I. Bongianin; A. Viganò; V. Giacomet; P. Erba; F. Salvini; GV. Zuccotti; M. Giovannini; G. Ferraris; R. Lipreri; C. Moretti; M. Cellini; MC. Cano; P. Paolucci; A. Guarino; E. Bruzzese; G. De Marco; L. Tarallo; F. Tancredi; C. Giaquinto; M. Pennazzato; O. Rampon; ER Dalle Nogare; A. Sanfilippo; A. Romano; M. Saitta; I. Dodi; A. Barone; A. Maccabruni; Consolini R; Legitimo A; et al|
|Titolo:||Persistently high IgA serum levels are a marker of immunological or virological failure of combined antiretroviral therapy in children with perinatal HIV-1 infection|
|Anno del prodotto:||2005|
|Digital Object Identifier (DOI):||10.1111/j.1365-2249.2005.02756.x|
|Appare nelle tipologie:||1.1 Articolo in rivista|