Changes in frequency of HIV-1-specific cytotoxic T cell precursors and circulating effectors after combination antiretroviral therapy in children

Combination antiretroviral therapy has had a major role in reducing human i mmunodeficiency virus type 1 (HIV-1) plasma viral loads in HIV-1-infected a dults but a variable effect in infants, in whom complete viral suppression appears to be less readily achieved. In adults, after the reduction in plas ma viremia, there is a decrease in the numbers of circulating cytotoxic T c ell (CTL) effecters and precursors in the majority of patients. This longit udinal study assessed the effect of combination drug therapy on the frequen cy of HIV-1-specific CTL responses in 8 HIV-1-infected children. Following treatment, the frequency of HIV-1-specific CTL responses initially increase d, especially in children with incomplete viral suppression but with increa sing CD4(+) cell counts. In children with complete viral suppression, the f requency of HIV-1-specific CTL responses decreased, suggesting that viral r eplication is required to maintain CTL responses in the systemic circulatio n.