NEW YORK -- July 2, 2008 -- Children whose immune systems rebound after treatment with highly active antiretroviral therapy (HAART) for HIV infection face an increased risk of developing asthma, according to a study published in the Journal of Allergy and Clinical Immunology.
"We think this occurs because … CD4 cells increase in children treated with highly active antiretroviral therapy," said lead author William T. Shearer, MD, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas. CD4 cells are thought to be associated with the inflammation in the lung tissue that accompanies asthma.
Dr. Shearer and colleagues sought to determine whether children with HIV receiving HAART have a higher incidence of asthma than children with HIV not receiving HAART.
The study, which was part of the National Institutes of Health Women and Infants Transmission Study, included 2,664 children born to women with HIV. Of the children in the study, 193 were HIV+.
The children with HIV receiving HAART had higher CD4(+) T-cell percentages, lower CD8(+) T-cell percentages, and lower viral burdens than the HIV+ children not receiving HAART (P <= .05 vs P <= .01).
The cumulative incidence of asthma medication use in children with HIV receiving HAART at 13.5 years increased to 33.5% versus 11.5% in HIV+ children not receiving HAART (hazard ratio [HR] = 3.34, P = .01) and was equal to that in children not infected with HIV.
Dr. Shearer said a study that evaluates the lung function of children with HIV receiving HAART 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.
SOURCE: Baylor College of Medicine
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