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Drug cocktail found to help children with AIDS live longer by Jonathan Maze Of The Post and Courier Staff The drug cocktail that has turned AIDS from a deadly disease into a chronic condition in adults works on kids, too.       In a four-year study, researchers at the Harvard School of Public Health and the Pediatric AIDS Clinical Trial Group—which includes the Medical University of South Carolina—have found that combination therapy including protease inhibitors significantly reduces the risk of death in children and adolescents with the disease.       The study of 1,028 HIV-positive children and teens is being reported in the New England Journal of Medicine.       “The kids are doing much better,” said George Johnson, M.D., an infectious disease specialist and the principal investigator for Pediatric AIDS Clinical Trials Group trials at MUSC.       Since 1996, most American adults with AIDS have taken a combination of drugs, including protease inhibitors, that has successfully managed the disease, greatly reducing the risk of death. Protease is part of HIV, and when blocked, causes HIV to make inert copies of itself, which cannot infect cells.       Definitive results as to whether the treatment would work on children have not been available, in part because availability of the drugs for children has been slower. In addition, many physicians didn’t prescribe the drugs because of the uncertainty over whether they would help children. They also worried about side effects.       In 1996, 7 percent of children in the study were receiving the drug cocktail. As the drugs became more accessible, that percentage grew, and in 1999, 73 percent of the children were on the prescriptions.    Within that time, mortality in the group declined from 5.3 percent in 1996 to 0.7 percent in 1999.       “That’s substantial,” Johnson said, adding that the study was the first to demonstrate the effectiveness of the treatment in lowering the mortality of children with AIDS.       Researchers took into account several variables, such as ethnicity, height, weight, sex, age and parents’ education level. They found the combination therapy including protease inhibitors was uniformly successful.       Other studies found that combination therapy not only decreases the risk of death, it improves growth and immune function and lowers the incidence of infectious complications.       Among adults, combination therapy including protease inhibitors has been associated with side effects such as hyperglycemia, lipodystrophy or an odd distribution of fat, bone mineral loss and other complications. Those are issues the authors say should be addressed so that children who undergo the combination therapy in their formative years are not adversely affected.       “It does give HIV a different perspective,” Johnson said. “It’s changing from an acute, highly fatal disease to a chronic illness that’s going to require an approach that’s more like dealing with diabetes, which requires lifelong management.” Editor's note: The article ran Nov. 22 in the Post and Courier and is reprinted with permission.