ANTIRETROVIRAL THERAPY IS ASSOCIATED WITH A DECREASE IN UNINTEGRATED HIV-1 DNA IN PEDIATRIC-PATIENTS

Good markers for monitoring the efficacy of antiretroviral therapy in children do not currently exist. This study examined the effect of ant iretroviral therapy on human immunodeficiency virus (HIV-1) unintegrat ed DNA (uDNA), integrated DNA (iDNA), percent uDNA, immune complex dis sociated (ICD) p24 antigenemia, and plasma viral titer. Seven children were followed at therapy initiation and at similar to-3- and 10-month intervals. HIV-1 uDNA was detected in all children prior to start of therapy (average percent uDNA, 43%). At 3 months, the percent HIV uDNA decreased in all patients to an average of 18% (p = 0.01) and at 10 m onths decreased to an average of 1%. In contrast, the amount of HIV iD NA was relatively constant after initiation of therapy. ICD HIV p24 an tigen was detected in all patients prior to therapy (average, 538 pg/m l). Over the study period, the ICD p24 antigen level decreased in thre e patients and remained relatively unchanged in four patients. Plasma cultures of HIV-1 were positive in only one of the seven patients prio r to therapy. Among the methods evaluated, measurement of uDNA was the only parameter which reliable decreased after initiation of nucleosid e therapy.