Non-expensive and low-complexity surrogate markers for monitoring the response to combined antiretroviral therapy (combined-ART) are needed in poor-resource settings where routine assessment of CD4+ T-lymphocyte count and viral load can not be afforded. We longitudinally evaluated Ig serum levels in 234 HIV-1 infected children receiving combined-ART with ≥ 3 drugs. Since Ig levels physiologically vary with age, differences at different age periods were evaluated as differences in z-scores calculated using the mean and standard deviation of the normal population for each age period. Data from 17 (7·3%) children with immunological failure and from 54 (23·1%) children with virological failure of combined-ART were compared with data from not-failed children. At baseline children with immunological failure showed higher IgM z-scores (P = 0·042) than children without. After 3–12 months of therapy immunologically failed children displayed higher viral loads (P < 0·0001) and IgA (P = 0·043) z-scores than not-failed children. Similarly, at the same follow-up time, children with virological failure showed lower CD4+ T-lymphocyte percentages (P = 0·005) and higher IgA z-scores (P < 0·0001) than not-failed children. No difference in IgG or IgM z-scores was evidenced between failed and not-failed children after 3–12 months of therapy. In conclusion, IgA serum level is a cheap and low-complexity marker of immunological or virological failure of combined-ART which might be adopted in poor-resource settings.

Persistently high IgA serum levels are a marker of immunological or virological failure of combined antiretroviral therapy in children with perinatal HIV-1 infection

BEZZI, Teresa Maria;FIUMANA, Elisa;
2005

Abstract

Non-expensive and low-complexity surrogate markers for monitoring the response to combined antiretroviral therapy (combined-ART) are needed in poor-resource settings where routine assessment of CD4+ T-lymphocyte count and viral load can not be afforded. We longitudinally evaluated Ig serum levels in 234 HIV-1 infected children receiving combined-ART with ≥ 3 drugs. Since Ig levels physiologically vary with age, differences at different age periods were evaluated as differences in z-scores calculated using the mean and standard deviation of the normal population for each age period. Data from 17 (7·3%) children with immunological failure and from 54 (23·1%) children with virological failure of combined-ART were compared with data from not-failed children. At baseline children with immunological failure showed higher IgM z-scores (P = 0·042) than children without. After 3–12 months of therapy immunologically failed children displayed higher viral loads (P < 0·0001) and IgA (P = 0·043) z-scores than not-failed children. Similarly, at the same follow-up time, children with virological failure showed lower CD4+ T-lymphocyte percentages (P = 0·005) and higher IgA z-scores (P < 0·0001) than not-failed children. No difference in IgG or IgM z-scores was evidenced between failed and not-failed children after 3–12 months of therapy. In conclusion, IgA serum level is a cheap and low-complexity marker of immunological or virological failure of combined-ART which might be adopted in poor-resource settings.
2005
E., Chiappini; L., Galli; P. A., Tovo; C., Gabiano; M., de Martino; P., Osimani; R., Cordiali; D., De Mattia; M., Manzionna; C., Di Bari; M., Ruggeri; M., Masi; A., Miniaci; F., Specchia; M., Ciccia; M., Lanari; F., Baldi; L., Battisti; C., Fiorino; C., Dessı`; C., Pintor; M., Dedoni; M. L., Fenu; R., Cavallini; E., Anastasio; F., Merolla; M., Sticca; G., Pomero; Bezzi, Teresa Maria; Fiumana, Elisa; F., Bonsignori; P., Gervaso; E., Seini; M. T., Cecchi; D., Cosso; A., Timitilli; M., Stronati; A., Plebani; R., Pinzani; I., Bongianin; A., Vigano`; V., Giacomet; P., Erba; F., Salvini; G. V., Zuccotti; M., Giovannini; G., Ferraris; R., Lipreri; C., Moretti; M., Cellini; M. C., Cano; P., Paolucci; E., Bruzzese; G., De Marco; L., Tarallo; F., Tancredi; M., Pennazzato; O., Rampon; E. R., Dalle Nogare; A., Sanfilippo; A., Romano; M., Saitta; I., Dodi; A., Barone; A., Maccabruni; R., Consolini; A., Legitimo; C., Magnani; P., Falconieri; C., Fundaro`; O., Genovese; A., Panzanella; A. M., Casadei; A., Martino; C., Concato; G., Anzidei; G., Bove; S., Cerilli; S., Catania; C., Ajassa; A., Ganau; L., Cristiano; A., Mazza; A., Di Palma; F., Mignone; C., Riva; C., Scorfaro; V., Portelli; M., Rabusin; A., Pellegatta; M., Molesini
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11392/522627
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