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发帖数: 1822 | 1 Children with HIV in Asia resistant to AIDS drugs
By Tan Ee Lyn
HONG KONG | Thu Dec 1, 2011
http://www.reuters.com/article/2011/12/01/us-children-asia-drug
idUSTRE7B025520111201
Teenagers in Asia receiving treatment for HIV are showing early signs of
osteoporosis and children as young as five are becoming resistant to
AIDS
drugs, an anti-AIDS group said on Thursday, urging more attention be
given
to young HIV patients.
The finding, made available on World AIDS Day, is a reminder that while
more
people in Asia now have access to basic AIDS drugs, improved medicines
remain out of reach and patients -- both adults and children -- still
suffer
from inadequate care.
In Asia, some 160,000 children are infected with the human
immunodeficiency
virus (HIV), which causes AIDS. Of these, 57,000 require treatment but
only
30,000 were receiving it as of the end of 2008, according to UNICEF.
Researchers at TREAT Asia found children as young as five were
developing
resistance to AIDS drugs and may soon require improved, more expensive
medicines, which are not available for them yet.
"In our cohort, about 14 percent of the children have failed first-line
drugs ... Some of the children who are already on second-line are under
the
age of five," Annette Sohn, director of TREAT Asia, told Reuters in a
phone
interview.
Poor adherence to the timing or frequency of taking AIDS drugs can
result in
resistance. But in Asia, resistance is also due to the lack of drug
formulations for children.
"We all made some mistakes on how we managed patients with HIV in the
beginning of the epidemic," Sohn said. "We used adult tablets. We had no
pediatric formulations in our countries."
Sohn said health experts and drug providers need to find ways to make
third-
line, more powerful drugs available for children in poor countries. Such
medications are available or subsidized in rich nations but very
expensive
and sometimes unavailable in developing 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."
A long-term study of 4,000 HIV patients under the age of 23 in Asia by
TREAT
Asia also showed that a high percentage of teenagers had low bone
mineral
density, a precursor of 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.
"That 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."
Sohn, a pediatric specialist for children with HIV/AIDS, said this may
also
be due to toxic effects that some AIDS drugs, such as tenofovir, have on
bones.
"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 the side effects, and
having access to alternate drugs if they do arise."
The study covers Thailand, Vietnam, Malaysia, Cambodia, Indonesia and
India.
TREAT Asia is a network of clinics, hospitals and research institutions
working together to improve treatment access. | m******1
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