Reuters (12.01.11) - Thursday, December 08, 2011
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
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."