April 22, 2013

HIV Drug Cocktail Protect Hearts of Children With Virus

By Nicole Ostrow

April 22, 2013

Potent cocktails of AIDS drugs appear to protect the hearts of HIV-infected children against the ravages of the virus, according to a study.

Children and teens with HIV who took combinations of at least three antiretroviral medicines had fewer instances of heart disease and damage than kids in an older study who received little to no medicine, according to research today in JAMA Pediatrics. In the early 1990s, children with HIV weren’t treated with AIDS drugs or only received a single medicine.

Before the current treatments, called highly active antiretroviral therapies, or HAART, became available, about half of kids with HIV who died did so because their hearts were damaged, said Steven Lipshultz, the lead study author. The results released today indicate that long-term, or lifelong, use of combination therapies to clear the virus may prevent cardiac harm, researchers said.

“One of the miracles of modern medicine related to HIV is coming up with medicines that can’t eliminate HIV but they dramatically reduce it,” Lipshultz, a professor of pediatrics at the University of Miami Miller School of Medicine, said today in a telephone interview. “In addition to dramatically reducing it, it seems to help have a more healthy heart because there’s less virus and an overall normal immune system in these healthy children.”

Ultrasound Change

Because of heart damaged caused by HIV, doctors have required kids with the virus to undergo routine echocardiograms, or ultrasounds of their heart, Lipshultz said. Today’s study also shows that frequent ultrasounds, which cost more than $1,000, can now be stopped, he said.

“The routine monitoring by echo cardiograms is probably not necessary except for in those who we might have a concern,”he said. The findings also have more practical implications in developing countries where HIV rates are the highest and ultrasounds are not always available, he said.

Researchers in the study looked at 325 children who were HIV positive at birth and received a cocktail of antiretroviral medicines and 189 children who were exposed to HIV but not infected with the disease. They also looked at another 70 HIV-infected children from an older study who didn’t get the drugs.

The condition of the heart in children who received the drug cocktail was “significantly closer to normal” than those kids who were HIV positive and didn’t received the drugs, Lipshultz said.

The researchers are now trying to determine which part of the antiretroviral therapies are the most helpful to the heart and which may cause damage to the heart, he said. They are also reviewing the blood work of these studies to see if they can come up with a blood test to determine heart damage rather than using an ultrasound.

Antiretroviral treatments include Johnson & Johnson (JNJ)’s Prezista, Gilead Sciences Inc. (GILD)’s Truvada, Bristol-Myers Squibb Co. (BMY)’s Sustiva and GlaxoSmithKline Plc (GSK)’s Ziagen.

To contact the reporter on this story: Nicole Ostrow in New York at nostrow1@bloomberg.net 

To contact the editor responsible for this story: Reg Gale at rgale5@bloomberg.net


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