Immunology and the REACH study: HIV immunology and preliminary findings

This review paper presents the immunology findings in human immunodeficienc y virus (HIV) infected and uninfected youth in the Reaching for Excellence in Adolescent Care and Health (REACH) Project within the context of basic a nd HIV immunology concepts. Methods employed in the study for specimen coll ection, management, and laboratory analysis are presented. This paper revie ws published analyses of cross-sectional data; longitudinal analyses are un derway. These preliminary data extend the work of others in demonstrating t he potential for substantial thymic reserve in youth. This finding in HIV i nfected adolescents has implications for a fuller response to antiretrovira l or immune-based therapies compared to that seen in adults. Dysregulation in mucosal immunity may appear before systemic HIV effects are seen and req uires attention particularly to screening and treatment of genital co-infec tions. REACH has demonstrated gender differences in immunologic measures ir respective of HIV infection status. (C) Society for Adolescent Medicine, 20 01.