Restoration of recent thymic emigrant CD4+ T cells is associated with sustained adherence to antiretroviral treatment in HIV-infected children

To evaluate the levels of recent thymic emigrant (RTE) CD4(+) T cells in HIV-infected children and to explore the associations among their frequency, antiretroviral treatment (ART) adherence, and CD4(+) T cell restoration. The group evaluated comprised 85 HIV-infected patients classified as subjects with moderate or severe immunosuppression or as those with no evidence of immunosuppression. To evaluate the association between the frequency of RTE CD4(+) T cells and ART adherence, 23 of the 85 patients were evaluated at two different time points during a one-year follow-up period. Children with severe immunosuppression had lower frequencies of RTE CD4(+) T cells compared with children without evidence of immunosuppression (P < .001). The frequency of RTE CD4(+) T cells in children with a high rate of adherence was significantly higher (P < .05) than that observed among those with suboptimal adherence. The latter group presented with infectious intercurrences on admission that decreased after initiation of treatment along with improved CD4(+) and RTE naive CD4(+) T cells counts. The adequate ART adherence is essential for immune reconstitution, which might be reflected by the levels of RTE CD4(+) T cells.