Study: Protease Inhibitors Cut Death Rate, Boost Health in Children, Too

A four-year study of 1,028 HIV-infected children and teenagers has found that combining protease inhibitors with standard AIDS drugs cut the risk of death by two-thirds, to less than 1 percent annually.

Reported in last week's New England Journal of Medicine (Vol. 345; No. 21), the study looked at children treated for HIV at 40 pediatric AIDS clinics around the country. Their doctors and their parents decided on the course of treatment for each child.

Investigators reported that some children improved dramatically. "The children are acting as if they didn't have AIDS," said Dr. James M. Oleske, director of pediatric infectious diseases at University of Medicine and Dentistry of New Jersey in Newark. "They started growing, they started gaining weight, they started enjoying life. They didn't develop infections as much."

Because of these drug advances, some children infected with HIV around the time of birth are now in college; doctors once worried that they would not live to finish grammar school. Physicians were slow to prescribe protease inhibitors to children because of side effects. However, by 1999, 73 percent of children in the study were taking protease inhibitors along with standard AIDS drugs. During the period from 1996 (when only 7 percent of children were taking protease inhibitors) to 1999, the death rate of study participants dropped from 5.3 percent to 0.7 percent.

"This is a great study," said Sharon Nachman, director of the Maternal Child HIV Center at the State University of New York at Stony Brook. "It shows we've moved from a fatal disease to a chronic illness that can be treated."

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