Children with HIV in Asia Suffer Resistance to AIDS Drugs

Researchers with the HIV/AIDS network TREAT Asia are calling for improved access to advanced pediatric HIV drugs. The collaboration of clinics, hospitals, and research institutions has released a new long-term study of 4,000 patients under age 23 in six Asian countries: It finds growing evidence of drug resistance and loss of bone density among the youths.

“In our cohort, about 14 percent of the children have failed first-line drugs ... . Some of the children who are already on second-line [drugs] are under the age of five,” said TREAT Asia Director Annette Sohn, a pediatric HIV/AIDS specialist.

Drug resistance can be caused by poor adherence to AIDS drug regimens, though in Asia it also is due to a lack of formulations for children. “We all made some mistakes on how we managed patients with HIV in the beginning of the epidemic,” said Sohn. “We used adult tablets, we had no pediatric formulations in our countries.”

“Unless we develop access to third-line drugs, we are going to find ourselves in a clinic room with a patient that there is nothing left and we have no other drug to give them,” Sohn said.

The study - carried out in Cambodia, India, Indonesia, Malaysia, Thailand, and Vietnam - found a high percentage of teenage patients with low bone mineral density, a precursor to osteoporosis. “We did a special X-ray on these teenagers, who are about 16 years old, and found that 15 percent of them had low bone mass,” Sohn said. “This is not normal. Kids are not supposed to have low bone mass when they’re 16 years old and that’s because of the effect of HIV on their bodies ... brain, bone, immune system.”

Though she noted this may also be due to toxic effects that some AIDS drugs, such tenofovir, have on bone, Sohn added, “It is not so much about avoiding one drug or another but being aware of these side effects, studying what drug doses will suppress the virus while not being toxic, having the resources to monitor side effects, and having access to alternative drugs if they do arise.”

Reuters (12.01.11):: Tan Ee Lyn