Ogunshola Funsho J, Khan Ruhul A, Ghebremichael Musie
Ragon Institute of MGH, MIT, and Harvard, 600 Main Street, Cambridge, MA, 02139, USA.
Department of Mathematics, University of Arizona, 617 N. Santa Rita Ave., Tucson, AZ, 85721, USA.
BMC Res Notes. 2025 Jan 7;18(1):6. doi: 10.1186/s13104-024-07032-y.
Immune reconstitution following the initiation of combination antiretroviral therapy (cART) significantly impacts the prognosis of individuals infected with human immunodeficiency virus (HIV). Our previous studies have indicated that the baseline CD4 T cells count and percentage before cART initiation are predictors of immune recovery in TB-negative children infected with HIV, with TB co-infection potentially causing a delay in immune recovery. However, it remains unclear whether these predictors consistently impact immune reconstitution during long-term intensive cART treatment in TB-negative/positive children infected with HIV.
We confirmed that the baseline CD4 T cell count is a significant predictor of immune recovery following long-term intensive cART treatment among children aged 0 to 13 years. Children with lower CD4 T cell count prior cART initiation did not show substantial immunological recovery during the follow-up period. Interestingly, children who were co-infected with TB and had higher baseline CD4 T cell count eventually achieved good immunological recovery comparable to the TB-negative HIV-infected children. Hence, the baseline CD4 T cell count at the onset of treatment serves as a reliable predictor of immunological reconstitution in HIV-infected children with or without TB co-infection. Taken together, this follow-up study validates our previous findings and further establishes that initiating cART early alongside early HIV testing can help prevent the diminished CD4 T cell count associated with inadequate immunological reconstitution.
启动联合抗逆转录病毒疗法（cART）后的免疫重建对感染人类免疫缺陷病毒（HIV）的个体的预后有显著影响。我们之前的研究表明，在开始cART之前的基线CD4 T细胞计数和百分比是HIV感染的结核阴性儿童免疫恢复的预测指标，合并结核感染可能会导致免疫恢复延迟。然而，在HIV感染的结核阴性/阳性儿童长期强化cART治疗期间，这些预测指标是否始终影响免疫重建仍不清楚。
我们证实，基线CD4 T细胞计数是0至13岁儿童长期强化cART治疗后免疫恢复的重要预测指标。在开始cART之前CD4 T细胞计数较低的儿童在随访期间未显示出实质性的免疫恢复。有趣的是，合并结核感染且基线CD4 T细胞计数较高的儿童最终实现了与结核阴性的HIV感染儿童相当的良好免疫恢复。因此，治疗开始时的基线CD4 T细胞计数可作为有或无结核合并感染的HIV感染儿童免疫重建的可靠预测指标。综上所述，这项随访研究验证了我们之前的发现，并进一步证实早期启动cART以及早期进行HIV检测有助于预防与免疫重建不足相关的CD4 T细胞计数减少。
