P028: Effectiveness of an antiretroviral regimen based on genotyping data in HIV-1 highly experimented children to antiretroviral therapy

Abstract

Antiretroviral therapies have proved life-saving in HIV infection, dramatically reducing morbidity and mortality.With longer survival, morbidities and mortalities in HIV infection are increasingly similar to the morbidities and mortalities associated with ageing.In treated HIV infection, the risk of these morbidities and mortalities is linked to immune activation, inflammation and coagulation indices.And in persons with treated HIV infection, failure to restore circulating CD4 T cell numbers is associated with a greater risk of morbidities and mortalities as well as to heightened levels of inflammation and coagulation.The drivers of immune activation, inflammation and coagulation in treated HIV infection are incompletely defined and could be related to sustained low levels of viral replication in tissues, to translocation of microbial products across a damaged gut mucosa, to replication of co-pathogens such as cytomegalovirus, to increased levels of inflammatory lipids, or to homeostatic responses to lymphocytopenia that may drive expansion of CD8 T cell numbers.We present here models that link inflammation and coagulation to morbid outcomes as well as to the pathogenesis of CD4 T cell restoration failure and CD8 T cell expansion.