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041			_aeng
100			_9443 _aRojo Conejo, Pablo _ePediatría
245	0	0	_aEstablishment and Replenishment of the Viral Reservoir in Perinatally HIV-1-infected Children Initiating Very Early Antiretroviral Therapy. _h[artículo]
260			_bClinical infectious diseases : an official publication of the Infectious Diseases Society of America, _c2015
300			_a61(7):1169-78.
500			_aFormato Vancouver: Martínez Bonet M, Puertas MC, Fortuny C, Ouchi D, Mellado MJ, Rojo P et al. Establishment and Replenishment of the Viral Reservoir in Perinatally HIV-1-infected Children Initiating Very Early Antiretroviral Therapy. Clin Infect Dis. 2015 Oct 1;61(7):1169-78.
501			_aPMID: 26063721 PMC4560905
504			_aContiene 40 referencias
520			_aBackground: Combination antiretroviral therapy (cART) generally suppresses the replication of the human immunodeficiency virus type 1 (HIV-1) but does not cure the infection, because proviruses persist in stable latent reservoirs. It has been proposed that low-level proviral reservoirs might predict longer virologic control after discontinuation of treatment. Our objective was to evaluate the impact of very early initiation of cART and temporary treatment interruption on the size of the latent HIV-1 reservoir in vertically infected children. Methods: This retrospective study included 23 perinatally HIV-1-infected children who initiated very early treatment within 12 weeks after birth (n = 14), or early treatment between week 12 and 1 year (n = 9). We measured the proviral reservoir (CD4(+) T-cell-associated HIV-1 DNA) in blood samples collected beyond the first year of sustained virologic suppression. Results: There is a strong positive correlation between the time to initiation of cART and the size of the proviral reservoir. Children who initiated cART within the first 12 weeks of life showed a proviral reservoir 6-fold smaller than children initiating cART beyond this time (P < .01). Rapid virologic control after initiation of cART also limits the size of the viral reservoir. However, patients who underwent transient treatment interruptions showed a dramatic increase in the size of the viral reservoir after discontinuation. Conclusions: Initiation of cART during the first 12 weeks of life in perinatally HIV-1-infected children limits the size of the viral reservoir. Treatment interruptions should be undertaken with caution, as they might lead to fast and irreversible replenishment of the viral reservoir.
710			_9446 _aServicio de Pediatría-Neonatología
856			_uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4560905/ _yAcceso libre
942			_2ddc _cART _n0