Virologic and immunologic outcomes after 24 weeks in HIV type 1-infected adolescents receiving highly active antiretroviral therapy

Patricia M. Flynn; Bret J. Rudy; Steven D. Douglas; Janet Lathey; Stephen A. Spector; Jaime Martinez; Margarita Silio; Marvin Belzer; Lawrence Friedman; Lawrence D'Angelo; James McNamara; Janice Hodge; Michael D. Hughes; Jane C. Lindsey; M. E. Pau; L. Noroski; W. Borkowsky; T. Hastings; S. Bakshi; M. Purswani; A. Puga; D. Cruz; M. J. O'Hara; A. J. Melvin; K. M. Mohan; C. L. Samples; M. Cavallo; M. E. Belzer; D. Tucker; M. Tanney; C. Vincent; A. C. Nyquist; K. C. Clevenger; J. E. Squires; O. Ramilo; R. Yogev; D. Fonken-Cloutier; K. Wilson; K. Bojan; J. Sever; S. Nesheim; R. Dennis; S. Rana; P. Yu; A. Wiznia; M. Chin; K. Dorio; A. Kovacs; J. Homans; D. Futterman; M. DeBellis; G. Stiebel; M. Acevedo; M. Gonzales; V. R. Bonagura; C. Colter; K. Knapp; S. DiScenza; R. B. van Dyke; L. Wenthold; R. M. Viani; L. Stangl; M. H. Rathore; A. Alvarez; G. B. Scott; A. Cody; C. Gamber; H. Gay; A. Palmer; R. Pass; M. Mancao

doi:10.1086/421521

Virologic and immunologic outcomes after 24 weeks in HIV type 1-infected adolescents receiving highly active antiretroviral therapy

Patricia M. Flynn, Bret J. Rudy, Steven D. Douglas, Janet Lathey, Stephen A. Spector, Jaime Martinez, Margarita Silio, Marvin Belzer, Lawrence Friedman, Lawrence D'Angelo, James McNamara, Janice Hodge, Michael D. Hughes, Jane C. Lindsey, M. E. Pau, L. Noroski, W. Borkowsky, T. Hastings, S. Bakshi, M. PurswaniA. Puga, D. Cruz, M. J. O'Hara, A. J. Melvin, K. M. Mohan, C. L. Samples, M. Cavallo, M. E. Belzer, D. Tucker, M. Tanney, C. Vincent, A. C. Nyquist, K. C. Clevenger, J. E. Squires, O. Ramilo, R. Yogev, D. Fonken-Cloutier, K. Wilson, K. Bojan, J. Sever, S. Nesheim, R. Dennis, S. Rana, P. Yu, A. Wiznia, M. Chin, K. Dorio, A. Kovacs, J. Homans, D. Futterman, M. DeBellis, G. Stiebel, M. Acevedo, M. Gonzales, V. R. Bonagura, C. Colter, K. Knapp, S. DiScenza, R. B. van Dyke, L. Wenthold, R. M. Viani, L. Stangl, M. H. Rathore, A. Alvarez, G. B. Scott, A. Cody, C. Gamber, H. Gay, A. Palmer, R. Pass, M. Mancao

Pediatrics

Research output: Contribution to journal › Article › peer-review

92 Scopus citations

Abstract

Background. Adolescents represent the fastest growing demographic group of new human immunodeficiency virus (HIV) infections in the United States. At present, there is little information available about their response to therapy. Methods. We studied 120 adolescents infected via high-risk behaviors who began receiving highly active antiretroviral therapy (HAART), to determine their virologic and immunologic response to therapy. Results. Subjects were enrolled at 28 sites of the Pediatric Acquired Immunodeficiency Syndrome Clinical Trials Group. After 16-24 weeks of HAART, 59% of subjects had reproducible undetectable virus loads, according to repeat measurements (virologic success). As enumerated by flow-cytometric analysis, increases in levels of CD4 helper cells (both naive and memory) and decreases in levels of CD8 suppressor cells were observed. Partial restoration of some immunologic parameters for patients who did not achieve virologic success was also observed, but to a more limited extent than for adolescents with virologic success. Adherence to HAART was the only predictor of achieving undetectable virus loads. Conclusions. Adolescents have the capacity to improve their immunologic status with HAART. Lower than expected success in virologic control is related to lack of adherence, and efforts to improve treatment outcome must stress measures to assure adherence to medication.

Original language	English (US)
Pages (from-to)	271-279
Number of pages	9
Journal	Journal of Infectious Diseases
Volume	190
Issue number	2
DOIs	https://doi.org/10.1086/421521
State	Published - Jul 15 2004

ASJC Scopus subject areas

General Medicine

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Flynn, P. M., Rudy, B. J., Douglas, S. D., Lathey, J., Spector, S. A., Martinez, J., Silio, M., Belzer, M., Friedman, L., D'Angelo, L., McNamara, J., Hodge, J., Hughes, M. D., Lindsey, J. C., Pau, M. E., Noroski, L., Borkowsky, W., Hastings, T., Bakshi, S., ... Mancao, M. (2004). Virologic and immunologic outcomes after 24 weeks in HIV type 1-infected adolescents receiving highly active antiretroviral therapy. Journal of Infectious Diseases, 190(2), 271-279. https://doi.org/10.1086/421521

Flynn, PM, Rudy, BJ, Douglas, SD, Lathey, J, Spector, SA, Martinez, J, Silio, M, Belzer, M, Friedman, L, D'Angelo, L, McNamara, J, Hodge, J, Hughes, MD, Lindsey, JC, Pau, ME, Noroski, L, Borkowsky, W, Hastings, T, Bakshi, S, Purswani, M, Puga, A, Cruz, D, O'Hara, MJ, Melvin, AJ, Mohan, KM, Samples, CL, Cavallo, M, Belzer, ME, Tucker, D, Tanney, M, Vincent, C, Nyquist, AC, Clevenger, KC, Squires, JE, Ramilo, O, Yogev, R, Fonken-Cloutier, D, Wilson, K, Bojan, K, Sever, J, Nesheim, S, Dennis, R, Rana, S, Yu, P, Wiznia, A, Chin, M, Dorio, K, Kovacs, A, Homans, J, Futterman, D, DeBellis, M, Stiebel, G, Acevedo, M, Gonzales, M, Bonagura, VR, Colter, C, Knapp, K, DiScenza, S, van Dyke, RB, Wenthold, L, Viani, RM, Stangl, L, Rathore, MH, Alvarez, A, Scott, GB, Cody, A, Gamber, C, Gay, H, Palmer, A, Pass, R & Mancao, M 2004, 'Virologic and immunologic outcomes after 24 weeks in HIV type 1-infected adolescents receiving highly active antiretroviral therapy', Journal of Infectious Diseases, vol. 190, no. 2, pp. 271-279. https://doi.org/10.1086/421521

@article{b562f89dd20646f585e9f9defe1c4236,

title = "Virologic and immunologic outcomes after 24 weeks in HIV type 1-infected adolescents receiving highly active antiretroviral therapy",

abstract = "Background. Adolescents represent the fastest growing demographic group of new human immunodeficiency virus (HIV) infections in the United States. At present, there is little information available about their response to therapy. Methods. We studied 120 adolescents infected via high-risk behaviors who began receiving highly active antiretroviral therapy (HAART), to determine their virologic and immunologic response to therapy. Results. Subjects were enrolled at 28 sites of the Pediatric Acquired Immunodeficiency Syndrome Clinical Trials Group. After 16-24 weeks of HAART, 59% of subjects had reproducible undetectable virus loads, according to repeat measurements (virologic success). As enumerated by flow-cytometric analysis, increases in levels of CD4 helper cells (both naive and memory) and decreases in levels of CD8 suppressor cells were observed. Partial restoration of some immunologic parameters for patients who did not achieve virologic success was also observed, but to a more limited extent than for adolescents with virologic success. Adherence to HAART was the only predictor of achieving undetectable virus loads. Conclusions. Adolescents have the capacity to improve their immunologic status with HAART. Lower than expected success in virologic control is related to lack of adherence, and efforts to improve treatment outcome must stress measures to assure adherence to medication.",

author = "Flynn, {Patricia M.} and Rudy, {Bret J.} and Douglas, {Steven D.} and Janet Lathey and Spector, {Stephen A.} and Jaime Martinez and Margarita Silio and Marvin Belzer and Lawrence Friedman and Lawrence D'Angelo and James McNamara and Janice Hodge and Hughes, {Michael D.} and Lindsey, {Jane C.} and Pau, {M. E.} and L. Noroski and W. Borkowsky and T. Hastings and S. Bakshi and M. Purswani and A. Puga and D. Cruz and O'Hara, {M. J.} and Melvin, {A. J.} and Mohan, {K. M.} and Samples, {C. L.} and M. Cavallo and Belzer, {M. E.} and D. Tucker and M. Tanney and C. Vincent and Nyquist, {A. C.} and Clevenger, {K. C.} and Squires, {J. E.} and O. Ramilo and R. Yogev and D. Fonken-Cloutier and K. Wilson and K. Bojan and J. Sever and S. Nesheim and R. Dennis and S. Rana and P. Yu and A. Wiznia and M. Chin and K. Dorio and A. Kovacs and J. Homans and D. Futterman and M. DeBellis and G. Stiebel and M. Acevedo and M. Gonzales and Bonagura, {V. R.} and C. Colter and K. Knapp and S. DiScenza and {van Dyke}, {R. B.} and L. Wenthold and Viani, {R. M.} and L. Stangl and Rathore, {M. H.} and A. Alvarez and Scott, {G. B.} and A. Cody and C. Gamber and H. Gay and A. Palmer and R. Pass and M. Mancao",

note = "Funding Information: 1Department of Infectious Diseases, St. Jude Children{\textquoteright}s Research Hospital, and Departments of 2Pediatrics and 3Preventive Medicine, University of Tennessee Health Science Center, Memphis; 4Children{\textquoteright}s Hospital of Philadelphia, Department of Pediatrics, The University of Pennsylvania School of Medicine, Philadelphia; 5Department of Pediatrics, University of California, San Diego, La Jolla; 6Department of Pediatrics, Stroger Hospital of Cook County/CORE Center, Chicago, Illinois; 7Department of Pediatrics, Tulane University School of Medicine, New Orleans, Louisiana; 8Department of Pediatrics, University of Miami School of Medicine, Miami, Florida; 9Children{\textquoteright}s Hospital, National Medical Center, and 10National Institute of Allergy and Infectious Diseases, Rockville, Maryland; 11Frontier Science and Technology Research Foundations, Inc., Amherst, New York; 12Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts Funding Information: Received 5 September 2003; accepted 8 January 2004; electronically published 18 June 2004. Presented in part: 8th Conference on Retroviruses and Opportunistic Infections, Chicago, 4–8 February 2001 (abstract 692). Financial support: Pediatric AIDS Clinical Trials Group of the National Institutes of Allergy and Infectious Diseases; Pediatric/Perinatal HIV Clinical Trials Network and Adolescent Trials Network of the National Institute of Child Health and Human Development. a Study group members are listed at the end of the text. Reprints or correspondence: Dr. Patricia M. Flynn, St. Jude Children{\textquoteright}s Research Hospital, 332 North Lauderdale St., Memphis, TN 38105 (pat.flynn@stjude.org).",

year = "2004",

month = jul,

day = "15",

doi = "10.1086/421521",

language = "English (US)",

volume = "190",

pages = "271--279",

journal = "Journal of Infectious Diseases",

issn = "0022-1899",

publisher = "Oxford University Press",

number = "2",

}

TY - JOUR

T1 - Virologic and immunologic outcomes after 24 weeks in HIV type 1-infected adolescents receiving highly active antiretroviral therapy

AU - Flynn, Patricia M.

AU - Rudy, Bret J.

AU - Douglas, Steven D.

AU - Lathey, Janet

AU - Spector, Stephen A.

AU - Martinez, Jaime

AU - Silio, Margarita

AU - Belzer, Marvin

AU - Friedman, Lawrence

AU - D'Angelo, Lawrence

AU - McNamara, James

AU - Hodge, Janice

AU - Hughes, Michael D.

AU - Lindsey, Jane C.

AU - Pau, M. E.

AU - Noroski, L.

AU - Borkowsky, W.

AU - Hastings, T.

AU - Bakshi, S.

AU - Purswani, M.

AU - Puga, A.

AU - Cruz, D.

AU - O'Hara, M. J.

AU - Melvin, A. J.

AU - Mohan, K. M.

AU - Samples, C. L.

AU - Cavallo, M.

AU - Belzer, M. E.

AU - Tucker, D.

AU - Tanney, M.

AU - Vincent, C.

AU - Nyquist, A. C.

AU - Clevenger, K. C.

AU - Squires, J. E.

AU - Ramilo, O.

AU - Yogev, R.

AU - Fonken-Cloutier, D.

AU - Wilson, K.

AU - Bojan, K.

AU - Sever, J.

AU - Nesheim, S.

AU - Dennis, R.

AU - Rana, S.

AU - Yu, P.

AU - Wiznia, A.

AU - Chin, M.

AU - Dorio, K.

AU - Kovacs, A.

AU - Homans, J.

AU - Futterman, D.

AU - DeBellis, M.

AU - Stiebel, G.

AU - Acevedo, M.

AU - Gonzales, M.

AU - Bonagura, V. R.

AU - Colter, C.

AU - Knapp, K.

AU - DiScenza, S.

AU - van Dyke, R. B.

AU - Wenthold, L.

AU - Viani, R. M.

AU - Stangl, L.

AU - Rathore, M. H.

AU - Alvarez, A.

AU - Scott, G. B.

AU - Cody, A.

AU - Gamber, C.

AU - Gay, H.

AU - Palmer, A.

AU - Pass, R.

AU - Mancao, M.

N1 - Funding Information: 1Department of Infectious Diseases, St. Jude Children’s Research Hospital, and Departments of 2Pediatrics and 3Preventive Medicine, University of Tennessee Health Science Center, Memphis; 4Children’s Hospital of Philadelphia, Department of Pediatrics, The University of Pennsylvania School of Medicine, Philadelphia; 5Department of Pediatrics, University of California, San Diego, La Jolla; 6Department of Pediatrics, Stroger Hospital of Cook County/CORE Center, Chicago, Illinois; 7Department of Pediatrics, Tulane University School of Medicine, New Orleans, Louisiana; 8Department of Pediatrics, University of Miami School of Medicine, Miami, Florida; 9Children’s Hospital, National Medical Center, and 10National Institute of Allergy and Infectious Diseases, Rockville, Maryland; 11Frontier Science and Technology Research Foundations, Inc., Amherst, New York; 12Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts Funding Information: Received 5 September 2003; accepted 8 January 2004; electronically published 18 June 2004. Presented in part: 8th Conference on Retroviruses and Opportunistic Infections, Chicago, 4–8 February 2001 (abstract 692). Financial support: Pediatric AIDS Clinical Trials Group of the National Institutes of Allergy and Infectious Diseases; Pediatric/Perinatal HIV Clinical Trials Network and Adolescent Trials Network of the National Institute of Child Health and Human Development. a Study group members are listed at the end of the text. Reprints or correspondence: Dr. Patricia M. Flynn, St. Jude Children’s Research Hospital, 332 North Lauderdale St., Memphis, TN 38105 (pat.flynn@stjude.org).

PY - 2004/7/15

Y1 - 2004/7/15

N2 - Background. Adolescents represent the fastest growing demographic group of new human immunodeficiency virus (HIV) infections in the United States. At present, there is little information available about their response to therapy. Methods. We studied 120 adolescents infected via high-risk behaviors who began receiving highly active antiretroviral therapy (HAART), to determine their virologic and immunologic response to therapy. Results. Subjects were enrolled at 28 sites of the Pediatric Acquired Immunodeficiency Syndrome Clinical Trials Group. After 16-24 weeks of HAART, 59% of subjects had reproducible undetectable virus loads, according to repeat measurements (virologic success). As enumerated by flow-cytometric analysis, increases in levels of CD4 helper cells (both naive and memory) and decreases in levels of CD8 suppressor cells were observed. Partial restoration of some immunologic parameters for patients who did not achieve virologic success was also observed, but to a more limited extent than for adolescents with virologic success. Adherence to HAART was the only predictor of achieving undetectable virus loads. Conclusions. Adolescents have the capacity to improve their immunologic status with HAART. Lower than expected success in virologic control is related to lack of adherence, and efforts to improve treatment outcome must stress measures to assure adherence to medication.

AB - Background. Adolescents represent the fastest growing demographic group of new human immunodeficiency virus (HIV) infections in the United States. At present, there is little information available about their response to therapy. Methods. We studied 120 adolescents infected via high-risk behaviors who began receiving highly active antiretroviral therapy (HAART), to determine their virologic and immunologic response to therapy. Results. Subjects were enrolled at 28 sites of the Pediatric Acquired Immunodeficiency Syndrome Clinical Trials Group. After 16-24 weeks of HAART, 59% of subjects had reproducible undetectable virus loads, according to repeat measurements (virologic success). As enumerated by flow-cytometric analysis, increases in levels of CD4 helper cells (both naive and memory) and decreases in levels of CD8 suppressor cells were observed. Partial restoration of some immunologic parameters for patients who did not achieve virologic success was also observed, but to a more limited extent than for adolescents with virologic success. Adherence to HAART was the only predictor of achieving undetectable virus loads. Conclusions. Adolescents have the capacity to improve their immunologic status with HAART. Lower than expected success in virologic control is related to lack of adherence, and efforts to improve treatment outcome must stress measures to assure adherence to medication.

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U2 - 10.1086/421521

DO - 10.1086/421521

M3 - Article

C2 - 15216461

AN - SCOPUS:3242731879

SN - 0022-1899

VL - 190

SP - 271

EP - 279

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

IS - 2

ER -

Virologic and immunologic outcomes after 24 weeks in HIV type 1-infected adolescents receiving highly active antiretroviral therapy

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