Long-term virologic and immunologic responses in human immunodeficiency virus type 1-infected children treated with indinavir, zidovudine, and lamivudine

Virologic and immunologic responses were examined for 33 human immunodefici ency virus (HIV)-infected children who participated for greater than or equ al to 96 weeks in a phase 1/2 protocol of 16 weeks of indinavir monotherapy , followed by the addition of zidovudine and lamivudine. At week 96, a medi an increase of 199 CD4(+) T cells/mL and a median decrease of 0.74 log(10) HIV RNA copies/mL were observed. The relationship between control of viral replication and CD4(+) T cell count was examined. Patients were categorized into 3 response groups on the basis of duration and extent of control of v iral replication. Of 21 children with a transient decrease in virus load of greater than or equal to0.7 log(10) HIV RNA copies/mL from baseline, 7 exp erienced sustained increases in CD4(+), CD4(+) CD45RA(+), and CD4(+) CD45RO (+) T cell counts. CD4(+) CD45RA(+) (naive) T cells were the major contribu tor to CD4(+) T cell expansion. Continued long-term immunologic benefit may be experienced by a subset of children, despite only transient virologic s uppression.