Long-term Virologic and Immunologic Responses in Human Immunodeficiency Virus Type 1-Infected Children Treated with Indinavir, Zidovudine, and Lamivudine

Virologic and immunologic responses were examined for 33 human immunodeficiency virus (HIV)–infected children who participated for ⩾96 weeks in a phase 1/2 protocol of 16 weeks of indinavir monotherapy, followed by the addition of zidovudine and lamivudine. At week 96, a median increase of 199 CD4+ T cells/μL and a median decrease of 0.74 log10 HIV RNA copies/mL were observed. The relationship between control of viral replication and CD4+ T cell count was examined. Patients were categorized into 3 response groups on the basis of duration and extent of control of viral replication. Of 21 children with a transient decrease in virus load of ⩾0.7 log10 HIV RNA copies/mL from baseline, 7 experienced sustained increases in CD4+, CD4+CD45RA+, and CD4+CD45RO+ T cell counts. CD4+CD45RA+ (naive) T cells were the major contributor to CD4+ T cell expansion. Continued long-term immunologic benefit may be experienced by a subset of children, despite only transient virologic suppression