|
|
 |
JACI Highlights - June 2008
Increased incidence of asthma in HIV-infected children treated with HAART in the NIH Women and Infants Transmission Study
Samuel B. Foster, MD, Kenneth McIntosh, MD, Bruce Thompson, PhD, Ming Lu, MS, Wanrong Yin, MS, Kenneth C. Rich, MD, Hermann Mendez, MD, Leslie K. Serchuck, MD, Clemente Diaz, MD, Mary E. Paul, MD, William T. Shearer, MD, PhD
Early in the HIV epidemic, babies born to HIV+ mothers were at high risk for also becoming HIV+. In the 1990's antiretroviral drugs became available to treat HIV+ babies to block a progression from HIV+ status to AIDS. Within a few years of initiating this new treatment, it was observed that use of a recommended drug combination of highly antiretroviral therapy (HAART) in these patients seemed to provoke inflammatory diseases such as asthma. In a study published in the Journal of Allergy and Clinical Immunology, Foster et al conducted a study of 2,664 children born to HIV+ mothers to determine whether HIV+ children receiving HAART (HIV+HAART+) have a higher incidence of asthma than HIV+ children not receiving HAART (HIV+AART-). The researchers were also interested in studying the children's CD4+ T cell levels, as recent animal studies suggest that CD4+ T cells are necessary for the development of asthma. HAART and other antiretroviral medications restore or preserve the CD4+ T cell counts of patients being treated for HIV to bolster their immunity. The authors found that the prevalence of asthma (determined by the use of prescribed asthma medications) among HIV+ HAART+ children was 33.5%, and only 11.5% for HIV+HAART- children. Additionally, the HIV+ HAART+ children had higher CD4+ T cell percentages, supporting the theory that the loss of CD4+ T cells in HIV+ children not on HAART is a protection against asthma, while the gain of CD4+ T cells through HAART therapy constitutes a risk for asthma. This profile of pediatric asthma may hold clues to explain the epidemic of asthma in the general pediatric population.
<back>
|
