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Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0000000000000144
HIV Reports

Early Highly Active Antiretroviral Therapy Enhances B-cell Longevity: A 5 Year Follow Up

Cagigi, Alberto PhD*; Rinaldi, Stefano MSc; Cotugno, Nicola MD*; Manno, Emma Concetta MD*; Santilli, Veronica MD*; Mora, Nadia MD*; Zangari, Paola MD*; Aquilani, Angela MD*; Tchidjou, Kuekou Hyppolite MD, PhD*; Giaquinto, Carlo MD; Bernardi, Stefania MD*; Rossi, Paolo MD, PhD*; Palma, Paolo MD, PhD*

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Abstract

Background:

We have previously reported that an early initiation of highly active antiretroviral therapy (HAART) in HIV-1 vertically infected children enhanced the function of memory B-cells gained during childhood routine vaccinations. On the other hand, a significant waning of immunity was observed for patients with a late treatment. In this follow-up study, we report data from a sample of patients in our cohort including late-treated patients being revaccinated with routine childhood vaccines.

Methods:

The levels of serum antibodies and cellular immunity were measured by antigen-specific enzyme-linked immunosorbent assay and B-cell ELISpot. Moreover, flow cytometry on the frequencies of mature-activated (CD10−CD21−) and double-negative (CD27–IgD–) B-cells as hallmarks of immune activation and immune senescence, respectively, was performed for all patients.

Results:

Reduced protective humoral immunity and cellular immunity to routine childhood vaccines was observed in late-treated patients. Moreover, we found that timing of HAART related with the frequencies of mature activated and double negative.

Conclusions:

Altogether the data presented in this follow-up study reenforce the importance for an early start of HAART in HIV-1 vertically infected individuals and suggest that timing of HAART is a fundamental factor to take into account for vaccination design in this population.

Copyright © 2014 by Lippincott Williams & Wilkins

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