June 15, 2004
Thanks to research advances over the past decade, children born with HIV are now surviving into their teens and early adulthood. However, such patients are likely to develop drug resistance due to sequential exposure to HIV treatments, including antiretroviral therapies.
Researchers from The Johns Hopkins Children's Center found that with careful planning and adherence to treatment plans, these HIV-positive patients can stay healthy. A new study, presented at the annual Pediatric Academic Societies' meeting in San Francisco, reported successful treatment of six HIV-positive children using tailored genotype-linked testing and a Web-based algorithm tool to assist in medication decisions.
"If HIV patients develop a drug resistance, the results could possibly be life-threatening, since resistance reduces the chance a new drug regimen will be successful," said the study's lead author, Nancy Hutton, MD, director of the Intensive Primary Care Clinic at the Children's Center.
Each patient in the Hopkins study underwent genotype analysis. Any detected gene mutations were entered into the algorithm. New regimens of three or more ARV agents from two or three classes were created for each patient based on the "least bad" combination of agents according to drug-resistance scores generated on the Web site http://hivdb.stanford.edu/. New regimens were initiated with directly observed therapy in an inpatient rehabilitation unit that included weekly monitoring for virus response.