Varicella-Zoster Virus—Specific Cell-Mediated Immunity in HIV-Infected Children Receiving Highly Active Antiretroviral Therapy

Varicella-Zoster Virus—Specific Cell-Mediated Immunity in HIV-Infected Children Receiving Highly Active Antiretroviral Therapy

Description: Clinical Infectious Diseases publishes clinically relevant articles on the pathogenesis, clinical investigation, medical microbiology, diagnosis, immune mechanisms, and treatment of diseases caused by infectious agents. As immunity plays an important role in the development of abnormal scars and keloids, the latter is unusual in HIV where immunity is low. There is limited evidence for the impact of ART on HZ occurrence among HIV-infected adults. Altogether 887 symptomatic HIV-patients (0.5 pc of the district population) were diagnosed. Varicella zoster vasculitis involving the brain was suspected. None of 5 patients who developed HZ during the study had VZV-CMI before developing HZ. After developing HZ, only the 2 HAART-compliant patients developed VZV-CMI.

Paul Volberding, the Editor-in Chief of AIDS Care, observed that “successful long-term care of people with HIV infection requires full cooperation and open communication, conscientiousness and compassion — on all sides.” That sort of cooperation — and that level of communication — are only possible when everyone involved in the process is speaking the same language. HIV preferentially destroys CD4+ T lymphocytes and interferes with regulatory mechanisms of the immune system, thereby weakening defenses against infection. Hope this helps. However, the extent of immune reconstitution in patients receiving HAART, especially in children, has not been clarified in detail. Throughout the study, all participants received individualized, confidential HIV counseling, risk-reduction counseling, couples counseling, free condoms, and treatment of sexually transmitted infections according to World Health Organization guidelines. Most of the people (62%) with incident herpes zoster were men, African American (75%) and heterosexual (52%). The skin problems here are further compounded by the high prevalence of HIV which commonly causes skin lesions [7].

Varicella-Zoster Virus—Specific Cell-Mediated Immunity in HIV-Infected Children Receiving Highly Active Antiretroviral Therapy
The effect of HAART on the epidemiology of HZ is unclear, although the prevalence of HZ does not appear to decrease soon after the initiation of HAART [5]. Even less is known about VZV-specific immune reconstitution in patients receiving HAART. His condition improved and was discharged on tenth day. Patients and methods. HIV-infected children or adolescents ⩽21 years of age who were receiving or initiating HAART were enrolled in Colorado and New York. HAART was defined as a 3-drug regimen containing at least 1 protease inhibitor or nonnucleoside reverse-transcriptase inhibitor. Exclusion criteria consisted of immunomodulator or corticosteroid therapy, pregnancy, and lymphoma or another malignancy.

Blood samples were obtained for immunologic and virologic assays, at periodic clinic visits. Anemia: A condition in which the blood is not able to deliver enough oxygen to the tissues. A responder cell frequency (RCF) assay, which measures VZV specificmemory CD4 cells by adding a limited dilution step to a lymphocyte proliferation assay, was performed using 24 wells/cell concentration, as described elsewhere [6]. Your privacy is strictly protected. Measurement of production of interferon (IFN)-γ was performed, as described elsewhere [7], by use of an EIA kit (Endogen), with a linear relationship between optical density readingand cytokine concentration ⩾2 pg/mL and a 4.7% intra-assay coefficient of variation. Data were analyzed using SAS (version 9.3; Cary, North Carolina). VZV antibodies were measured in accordance with EIA kit instructions (Diamedix).

Skin findings were recorded, and patients were categorized according to the WHO clinical stages at presentation using skin and findings in other body systems. The interval was calculated from the initiation of HAART (time 0). Time 0 was defined as data collected at the closest visit to the initiation of HAART and was the actual date of the initiation of HAART, not more than 3 months before the initiation of HAART, or not more than 1 month after the initiation of HAART. Eriguchi et al, reviewed records of surgical procedures done on HIV patients. Repeated-measures analysis of variance (ANOVA) techniques were used to evaluate the log HIV load and CD4 cell percentage data by responder status, with time viewed as a continuous variable, since the number and timing of visits were not uniform for all patients. The repeated-measures ANOVA assumes that there is a first-order autoregressive covariance structure within repeated measures for subjects and is a special case of a mixed-effects ANOVA, as described by Littell et al. [8].

Analyses and data management were performed by use of SAS (version 8.2; SAS Institute).

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