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Early HIV Treatment Extending Kids' Lives

The key is to give triple-drug therapy soon after birth, study finds

TUESDAY, May 10, 2005 (HealthDay News) -- New research provides more evidence that advanced treatments greatly improve the lives of children infected with the virus that causes AIDS, especially when the drugs are given shortly after birth.

However, specialists note that thousands of children remain HIV-positive and will need care as they face potential problems ranging from side effects to psychiatric disorders.

"It's fascinating to see how much better patients are doing," said Dr. Ram Yogev, director of maternal and pediatric HIV treatment at Children's Memorial Hospital in Chicago. "But we still have kids born with AIDS infection, even in the United States."

More than 9,300 children have progressed from HIV infection to AIDS in the United States as of December 2003, and officials estimate a total of 15,000 to 20,000 are HIV-positive.

"Although there are fewer children being born HIV-infected, there are more children who are being cared for now than ever in the AIDS epidemic. That's because the children who are HIV-infected are surviving into childhood and adolescent life," explained Dr. Stephen A. Spector, director of the Mother-Child-Adolescent HIV Program at the University of California at San Diego.

Drugs known as antiretrovirals revolutionized AIDS treatment in the mid- and late-1990s, extending the lives of thousands in the United States, including children. But specialists reportedly have had little information about when to begin treatment in infected babies.

In a new study, U.S. researchers led by Dr. Yvonne Maldonado, of Stamford University, examined the cases of 205 children born infected with HIV between 1988 and 2001 in Northern California. The virus transmits between infected mothers and unborn children through blood.

The researchers report their findings in the May 11 issue of the Journal of the American Medical Association.

They found that none of the 23 children who received full treatment with modern drug regimens progressed to the most serious phase of the disease in their first three years of life. The researchers didn't look at what happened to the children after the age of 3.

Babies who were treated with one or two drugs instead of the full treatment of three were more likely to get sicker. However, they did better if the drugs were given in the first two months of life instead of the third or fourth months.

Yogev, author of an accompanying commentary on the research, said the findings are a "celebration of success." But the public shouldn't "look at it as if we've reached a place where we can level off our efforts."

Specialists need to better understand the side effects of the drugs and the impact of allowing children to go through periods without taking them, he said. There are social effects too: HIV-infected children are more likely to develop psychological problems and tend to have lower IQs, he said.

"In the last few years, there's been a feeling in the United States that AIDS is over here, and everything is in the rest of the world. Few people want to invest in funding to study this unique population (of children). But there are specific issues that still need answers," Yogev said.

Spector agreed that more issues remain to be explored, including the long-term effects of the use of AIDS drugs. Doctors have no idea what the drugs will do to people who use them for decades. "That's why it's very important to follow children as they age," he said.

More information

Learn more about pediatric HIV from the Elizabeth Glaser Pediatric AIDS Foundation.

SOURCES: Ram Yogev, M.D., director, maternal and pediatric HIV treatment, Children's Memorial Hospital, Chicago; Stephen A. Spector, M.D., professor and vice chairman, Department of Pediatrics, chief, Division of Infectious Diseases, and director, Mother-Child-Adolescent HIV Program, University of California at San Diego; May 11, 2005, Journal of the American Medical Association
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