Children whose immune systems rebound after treatment with potent anti-viral drugs for HIV infection face an increased risk of developing asthma, said a federally funded consortium of researchers led by those from Baylor College of Medicine in a new report.
"We think this occurs because important immune system components called CD4 cells increase in children treated with highly active antiretroviral therapy," said Dr. William T. Shearer, professor of pediatrics and immunology at BCM in Houston and chief of the allergy and immunology service at Texas Children's Hospital. He is also senior author of the report. CD4 cells are thought to be associated with the inflammation in the lung tissue that accompanies asthma. When CD4 cells decline in children with HIV, their asthma symptoms also decrease.
Shearer and his colleagues evaluated the use of asthma medication among children with HIV who took the anti-HIV drugs and those who did not. They found that about one-third of those on the anti-HIV medications used asthma drugs compared to 11.5 percent of those who did not take anti-HIV drugs.
Shearer said a study that evaluates the lung function of children with HIV on anti-viral therapy would help explain how an increase in the immune system affects the risk of asthma.
"This AIDS model of asthma might help understand at a molecular level what is causing the current epidemic of asthma among children more generally," he said.
Others who took part in the study include Samuel B. Foster and Mary E. Paul of BCM and Texas Children's; Kenneth McIntosh of Harvard Medical School, Bruce Thompson, Ming Lu and Wanrong Yin of Clinical Trials and Surveys Corporation in Baltimore, MD., Kenneth C. Rich of the University of Illinois in Chicago, Hermann Mendez of the State University of New York in Brooklyn, Leslie K. Serchuck of the National Institute of Child Health and Development in Bethesda, MD and Clemente Diaz of the Puerto Rico School of Medicine in San Juan.
Funding for this work came from the National Institutes of Health, the Pediatric Research and Education Fund at Baylor College of Medicine; the David Fund and the Pediatric AIDS Fund and Immunology Research Fund at Texas Children's Hospital.
- Samuel B. Foster et al. Increased incidence of asthma in HIV-infected children treated with highly active antiretroviral therapy in the National. Journal of Allergy and Clinical Immunology, (in press) [link]
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