A new study shows that highly active antiretroviral therapy (HAART) may increase the risk of asthma in young children.
Dr. William T. Shearer of the Texas Children's Hospital in Houston and colleagues studied the rate of asthma in children born to HIV-positive mothers, comparing 193 children infected with HIV (113 treated with HAART and 80 never treated with HAART) and 2,471 HIV-negative children.
The rate of asthma medication use in HAART-treated children by age 13.5 years was 33.5 percent, compared with 11.5 percent in HIV-infected children not treated with HAART. Since the rate in HAART-treated children was just slightly higher than that in HIV-negative children, the researchers suggested that untreated HIV infection may actually protect against asthma.
Further analysis showed the increase in T cells levels achieved with HAART was to blame for the elevated asthma risk.
"Investigators have assumed that asthma is not a complication of pediatric HIV infection, because studies [conducted before HAART was introduced in the mid-1990s] did not detect the problem," explained Shearer. The reason was that without HAART, immune system T cells would drop, preventing an asthmatic reaction, he noted. "It was not until the era of HAART, which restored the [T cell] levels, that an increased incidence of asthma was noted."
Until additional studies verify the researchers' findings, Shearer cautioned physicians to be alert to the possibility that HAART may lead to asthma in children. Parents should also be made aware of this possible adverse outcome, he said.
The study, "Increased Incidence of Asthma in HIV-Infected Children Treated with Highly Active Antiretroviral Therapy in the National Institutes of Health Women and Infants Transmission Study," was published in the Journal of Allergy and Clinical Immunology (2008;122(1):159-165).
08/26/08
UNITED STATES: HIV Treatment May Provoke Asthma in Kids
Source: Reuters:: Karla Gale; Courtesy of the CDC National Center for HIV, STD, and TB Prevention