Immunomodulation with IVIg in our selected group of RRF patients with immunologic alterations enhanced clinical pregnancy and live birth rates. Our results may facilitate the design of future clinical trials of IVIg in this pathology.

Long-term HAART allowed for restoration of CD4+ cell counts and control of viral loads in HIV-1-infected children. However, initiating HAART after severe immunosuppression has occurred is detrimental for the restoration of the CD4+ cell count.

SUMMARYThe objective of this study was to monitor the changes in the immune system of HIV-infected children with moderate or severe immunodeficiency after highly active antiretroviral therapy (HAART), comprising a follow-up study in 14 HIV-infected children on HAART at two time points separated approximately by 11·8 ± 0·4 (9·9; 15·4) months. HIV-infected children had significantly lower TREC levels than the control group, but 1 year after HAART the levels increased significantly ( P < 0·05). In contrast, viral load (VL) did not change significantly. A positive correlation between T cell receptor excision circle (TREC) levels and both CD4 + T cell absolute counts ( r = 0·558; P = 0·05) and percentages ( r = 0·625; P = 0·030) was found. During follow-up on HAART, the percentages and absolute counts of naive CD4 + and CD8 + T cell subsets were increased significantly ( P < 0·05 + CD45RO + CD38 + absolute counts ( P < 0·05) decreased with respect to the baseline. Lymphoproliferative responses to pokeweed mitogen (PWM) before HAART were lower in HIV-infected children than the control group, but they recovered to normal levels after a year on HAART. Tumour necrosis factor (TNF)-a and interferon (IFN)-g production by PHA-activated peripheral blood mononuclear cells (PBMC) was lower before HAART ( P < 0·001), but reached similar levels to the control group 1 year after HAART. In HIV-infected children IgG, IgG 1 and IgG 3 plasma levels decreased significantly after HAART. The immune system reconstitution induced by HAART in HIV-infected children seems to be the consequence of decreased immune system activation and naive T cell reconstitution, mainly of thymic origin.

SUMMARYThe objective of this study was to investigate the relationship between peripheral blood CD4 1 T cell subsets and routine viro-immunological markers in vertically HIV-1-infected children undergoing highly active antiretroviral therapy (HAART). CD41 and CD8 1 T cell subsets were examined by three-colour flow cytometry. Plasma viraemia was quantified by a standardized molecular assay. A negative correlation between the %CD4 1 T cells and both viral load and the %CD8 1 T cells was observed. A strong positive correlation between the %CD4 T cells and naõ Ève, CD381 and non-activated CD4 1 T cell subsets was found, whereas the %CD4 T cells correlated negatively with the numbers of memory, activated and memory-activated CD4 1 T cell subsets. Elevated percentages of CD8 T cells were associated with increased memory and CD4

A clinical approach like short-term maraviroc exposure could be an additional resource to genetic and phenotypic HIV tropism assays. This clinical approach shows high concordance with Trofile, and could allow patients with non-reportable results by Trofile to benefit from maraviroc therapy.