%0 Journal Article
%A Guillén, Sara
%A Prieto, Luis
%A Jiménez de Ory, Santiago
%A González-Tomé, María Isabel
%A Rojo, Pablo
%A Navarro, María Luisa
%A Mellado, María José
%A Escosa, Luis
%A Sainz, Talía
%A Francisco, Laura
%A Muñoz-Fernández, María Ángeles
%A Ramos, José Tomás
%A CoRISpe (Cohorte Nacional de VIH pediátrica de la RED RIS)
%T Prognostic factors of a lower CD4/CD8 ratio in long term viral suppression HIV infected children.
%D 2019
%U https://hdl.handle.net/10668/24944
%X 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. 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. 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. Univariate analysis showed an association between CD4/CD8  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 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
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