Immunologic response to combination nucleoside analogue plus protease inhibitor therapy in stable antiretroviral therapy-experienced human immunodeficiency virus-infected children

The response of 40 immunologic parameters was studied for 147 clinically stable, protease inhibitor-naive, human immunodeficiency virus (HIV)-infected children aged 2-17 years when antiretroviral therapy was changed to either a dual nucleoside analogue regimen or a protease inhibitor-containing regimen. Immunologic response to therapy, as measured by lymphocyte subsets, 3-color flow cytometric measures, and lymphoproliferative assays, were investigated for changes in weeks 44 and 48. The most significant changes after baseline that were associated with the administration of a protease inhibitor- containing regimen were seen for percentages of CD8⁺/CD38⁺/HLA-DR⁺, CD8⁺/CD95⁺/CD28^-, and CD8. The percentages of CD8⁺/CD38⁺/ HLA-DR⁺ and CD8⁺/CD95⁺/CD28^- decreased from baseline medians of 33% and 46% to medians of 18% and 30% at week 44 (P <.0001 for both). Median CD4 cell count increased 168 cells/μL (from 694 cells/μL to 862 cells/μL; P = .02) by week 48 in this clinically stable population. Changes in lymphoproliferative responses to HIV antigens and recall antigens did not increase over time and between groups.