TY - JOUR
T1 - Early antiretroviral therapy in children perinatally infected with HIV
T2 - A unique opportunity to implement immunotherapeutic approaches to prolong viral remission
AU - Klein, Nigel
AU - Palma, Paolo
AU - Luzuriaga, Katherine
AU - Pahwa, Savita
AU - Nastouli, Eleni
AU - Gibb, Diane M.
AU - Rojo, Pablo
AU - Borkowsky, William
AU - Bernardi, Stefania
AU - Zangari, Paola
AU - Calvez, Vincent
AU - Compagnucci, Alexandra
AU - Wahren, Britta
AU - Foster, Caroline
AU - Munoz-Fernández, María Ángeles
AU - De Rossi, Anita
AU - Ananworanich, Jintanat
AU - Pillay, Deenan
AU - Giaquinto, Carlo
AU - Rossi, Paolo
PY - 2015/9/1
Y1 - 2015/9/1
N2 - From the use of antiretroviral therapy to prevent mother-to-child transmission to the possibility of HIV cure hinted at by the Mississippi baby experience, paediatric HIV infection has been pivotal to our understanding of HIV pathogenesis and management. Daily medication and indefinite antiretroviral therapy is recommended for children infected with HIV. Maintenance of life-long adherence is difficult and the incidence of triple-class virological failure after initiation of antiretroviral therapy increases with time. This challenge shows the urgent need to define novel strategies to provide long-term viral suppression that will allow safe interruption of antiretroviral therapy without viral rebound and any associated complications. HIV-infected babies treated within a few days of birth have a unique combination of a very small pool of integrated viruses, a very high proportion of relatively HIV resistant naive T cells, and an unparalleled capacity to regenerate an immune repertoire. These features make this group the optimum model population to investigate the potential efficacy of immune-based therapies. If successful, these investigations could change the way we manage HIV infection.
AB - From the use of antiretroviral therapy to prevent mother-to-child transmission to the possibility of HIV cure hinted at by the Mississippi baby experience, paediatric HIV infection has been pivotal to our understanding of HIV pathogenesis and management. Daily medication and indefinite antiretroviral therapy is recommended for children infected with HIV. Maintenance of life-long adherence is difficult and the incidence of triple-class virological failure after initiation of antiretroviral therapy increases with time. This challenge shows the urgent need to define novel strategies to provide long-term viral suppression that will allow safe interruption of antiretroviral therapy without viral rebound and any associated complications. HIV-infected babies treated within a few days of birth have a unique combination of a very small pool of integrated viruses, a very high proportion of relatively HIV resistant naive T cells, and an unparalleled capacity to regenerate an immune repertoire. These features make this group the optimum model population to investigate the potential efficacy of immune-based therapies. If successful, these investigations could change the way we manage HIV infection.
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U2 - 10.1016/S1473-3099(15)00052-3
DO - 10.1016/S1473-3099(15)00052-3
M3 - Article
C2 - 26187030
AN - SCOPUS:84939865004
VL - 15
SP - 1108
EP - 1114
JO - The Lancet Infectious Diseases
JF - The Lancet Infectious Diseases
SN - 1473-3099
IS - 9
ER -