Artículo
en Inglés
| SES-SP, SESSP-IIERPROD, SES-SP | ID: biblio-1021225
BACKGROUND:
Reports of posttreatment control following antiretroviral therapy (ART) have prompted the question of how common immune control of HIV infection is in the absence of ART. In contrast to adultinfection, where elite controllers have been very well characterized and constitute approximately 0.5% of infections, very few data exist to address this question in paediatric infection.
All but one of the elite controllers (91%) are females. The median age at which control of viraemia was achieved was 6.5 years. Five of these 11 (46%) children lost control of viraemia at a median age of 12.9 years. Childrenwho maintained control of viraemia had significantly higher absolute CD4þ cell counts in the period of elite control than those who lost viraemic control. On the basis of data available from these cohorts, the prevalence of elite controllers in paediatric infection is estimated to be 510-fold lower than in adults.
CONCLUSION:
Although conclusions are limited by the study design, these data suggest that, whilst paediatric elite control can be achieved, compared with adultelite controllers, this occurs rarely, and takes some years after infection to achieve. Also, loss of immune control arises in a high proportion of children and often relatively rapidly. These findings are consistent with the more potent antiviralimmune responses observed in adults and in females