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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*

The Pediatric Infectious Disease Journal: May 2014 - Volume 33 - Issue 5 - p e126–e131
doi: 10.1097/INF.0000000000000144
HIV Reports

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.

Supplemental Digital Content is available in the text.

From the *University Department of Pediatrics, DPUO, Unit of Immune and Infectious Diseases, Bambino Gesù Children’s Hospital, Piazza S. Onofrio; Department of Public Health, University of Rome, Tor Vergata, Rome; and Department of Pediatrics, University of Padova, Padova, Italy.

Accepted for publication October 11, 2013.

This study was supported by grants obtained from the Bambino Gesù Children’s Hospital, Rome, Italy. The authors have no other funding or conflicts of interest to disclose.

Last authorship was shared by P.R. and P.P.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (

Address for correspondence: Paola Parma, MD, PhD, University Department of Pediatrics, DPUO, Unit of Immune and Infectious Diseases, Bambino Gesù Children’s Hospital, Piazza S. Onofrio 4, 00165 Rome, Italy. E-mail:;

© 2014 by Lippincott Williams & Wilkins, Inc.