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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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New data on HIV medication in children?
Oct 6, 2010

I have represented a lot of Social Security disability applicants over the years. I know that in the past, there was concern about the long-term effects of HAART meds on children - who did not have a fully developed immune system when they contracted the virus and started medication (versus a newly diagnosed adult). Is there any new data regarding additional considerations / more severe side-effects in children precisely because their immune system did not fully develop? Social Security re-evaluates HIV / AIDS children (and all disabled children) when they turn 18. I want to know if there are more issues regarding development of the immune system, which will mean this individual, HIV+ since birth / childhood, will have more complications than a newly infected adult might face. THANK YOU SO MUCH!

Response from Dr. Henry

I am not the best person to answer that question. Younger persons with HIV infection often have a more pronounced CD4 recovery on effective ART compared to adults partly due to a larger/more functional thymus gland. Newer HIV regimens often get used somewhat later in children than adults but the trend in treatment has steadily been more effective, simpler, and safer (fewer side effects overall). I am inheriting patients from my pediatric colleagues who have survived their childhood/adolescence and now are young adults. Many have some residual (such as laggard growth) from their experience with HIV/AIDS over the preceding decades. Long term outcome remains to be determined since data is limited for persons surviving childhood HIV/AIDS and now living into their 20/30s and hopefully many decades beyond. Adherence issues, social, poverty, continuing stigma, questions about sexuality and having children are among the issues frequently discussed during visits. KH

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