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HIV-specific Elispot responses were investigated in 57 antiretroviral therapy-naïve children, of median age 9.9 years. CD8+ T-cell responses were detected in 96% children; Nef was the immunodominant protein. Responses broadened over time but there was no association between magnitude, breadth or specificity of response and viraemia. Gag-specific CD4+ T-cell responses, detectable in 26% children, correlated inversely with viraemia (R = -0.43, P < 0.001), suggesting that preservation of this cell population may be an important goal of therapeutic/vaccine strategies.

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