@article{3185012,
    title = "CD4 recovery following antiretroviral treatment interruptions in
children and adolescents with HIV infection in Europe and Thailand",
    author = "Galli, L. and Crichton, S. and Buzzoni, C. and Goetghebuer, T. and and Jourdain, G. and Judd, A. and Klein, N. and Jose Mellado, M. and and Noguera-Julian, A. and Kahlert, C. R. and Spoulou, V. and Scherpbier, H. and and Marques, L. and Collins, I. J. and Gibb, D. M. and Gonzalez Tome, Mi and and Warszawski, J. and Dollfus, C. and Koenigs, C. and Prata, F. and and Chiappini, E. and Naver, L. and Giaquinto, C. and Thorne, C. and and Marczynska, M. and Okhonskaia, L. and Borkird, T. and Attavinijtrakarn, and P. and Malyuta, R. and Volokha, A. and Ene, L. and Goodall, R. and and European Pregnancy Paediat HIV",
    journal = "Neurobehavioral HIV Medicine",
    year = "2019",
    volume = "20",
    number = "7",
    pages = "456-472",
    publisher = "Wiley",
    doi = "10.1111/hiv.12745",
    keywords = "antiretroviral therapy; paediatric; treatment interruption",
    abstract = "Objectives The aim of the study was to explore factors associated with
CD4 percentage (CD4%) reconstitution following treatment interruptions
(TIs) of antiretroviral therapy (ART). Methods Data from paediatric
HIV-infected cohorts across 17 countries in Europe and Thailand were
pooled. Children on combination ART (cART; at least three drugs from at
least two classes) for > 6 months before TI of >= 30 days while aged
CD4% at restart of ART (r-ART) and in the long term (up to 24 months
after r-ART) following the first TI was modelled using asymptotic
regression. Results In 779 children with at least one TI, the median age
at first TI was 10.1 [interquartile range (IQR) 6.4, 13.6] years and
the mean CD4% was 27.3% [standard deviation (SD) 11.0%]; the median
TI duration was 9.0 (IQR 3.5, 22.5) months. In regression analysis, the
mean CD4% was 19.2% [95% confidence interval (CI) 18.3, 20.1%] at
r-ART, and 27.1% (26.2, 27.9%) in the long term, with half this
increase in the first 6 months. r-ART and long-term CD4% values were
highest in female patients and in children aged TI. Long-term CD4% was
highest in those with a TI lasting 1 to <3 months, those with r-ART
after year 2000 and those with a CD4% nadir >= 25% (all P < 0.001).
The effect of CD4% nadir during the TI differed significantly (P =
0.038) by viral suppression at the start of the TI; in children with
CD4% nadir TI, recovery was better in those virally suppressed prior to
the TI; viral suppression was not associated with recovery in children
with CD4% nadir >= 25%. Conclusions After restart of ART following TI,
most children reconstituted well immunologically. Nevertheless, several
factors predicted better immunological reconstitution, including younger
age and higher nadir CD4% during TI."
}