The impact of early initiation of highly active antiretroviral therapy on the human immunodeficiency virus type 1-specific CD8 T cell response in children

This cross-sectional study investigated the effect of early highly active a ntiretroviral therapy (HAART) on human immunodeficiency virus (HIV) type 1- specific CD8 T cell responses in children. HIV-1-specific CD8 T cell respon ses were quantified using an enzyme-linked immunospot assay to measure inte rferon-gamma-secreting cells. HIV-l-infected children were classified by ti me of HAART initiation prior to age 1 year or after age 2 years as early (n = 24) or late (n = 28) treated, The magnitude and breadth of the HIV-1-spe cific CD8 T cell response was significantly lower in children receiving ear ly compared with late HAART treatment (P = .0007 and .0001, respectively). However, total CD8 T cell responses in the early HAART treatment group did not differ significantly from those of age-matched non-HAART-treated contro ls (n = 30), Thus, the reduced magnitude and breadth of the HIV-l-specific CD8 T cell response in early HAART-treated children is due to their younger age.