Guillén, SaraPrieto, LuisJiménez de Ory, SantiagoGonzález-Tomé, María IsabelRojo, PabloNavarro, María LuisaMellado, María JoséEscosa, LuisSainz, TalíaFrancisco, LauraMuñoz-Fernández, María ÁngelesRamos, José TomásCoRISpe (Cohorte Nacional de VIH pediátrica de la RED RIS)2025-01-072025-01-072019-08-05https://hdl.handle.net/10668/24944Combination 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/CD8enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/AdolescentAnti-Retroviral AgentsAntiretroviral Therapy, Highly ActiveCD4-CD8 RatioChildChild, PreschoolFemaleHIV InfectionsHIV-1HumansImmunityInfantInfant, NewbornMalePrognosisViral Loadresearch article31381604open access10.1371/journal.pone.02205521932-6203PMC6681936https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0220552&type=printablehttps://pmc.ncbi.nlm.nih.gov/articles/PMC6681936/pdf