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PUBLIC HEALTH Young HIV Patients Respond Well to Multidrug Care The mixed drug, or combination, therapy that has saved the lives of thousands of adults infected with HIV appears to work extremely well in HIV-positive children and adolescents, according to a study in the Nov. 22 New England Journal of Medicine. "The study documents very substantial reductions in mortality among children and adolescents," said Steve Gortmaker, HSPH senior lecturer on sociology in the Department of Health and Social Behavior and lead author of the study. "Prior to this we had evidence of improvements in viral loads, and a sense of reduced death, but now we have clear evidence." Gortmaker and his colleagues followed a cohort of 1,028 HIV-positive children and adolescents enrolled in AIDS research clinics prior to 1996, the year that combination therapy, a drug regimen that includes protease inhibitors, was first introduced. They followed the young people, drawn from a wide variety of socioeconomic and ethnic backgrounds, through 1999. Although in 1996 only 7 percent received combination therapy, by 1999, 73 percent were receiving the regimen. In that time, mortality dropped from 5.3 percent to 2.1 percent in 1997, 0.9 percent in 1998, and 0.7 percent in 1999. In addition to lower mortality rates, the children exhibited improved growth and immune function and fewer infectious complications. "Perhaps most importantly, we see large and equivalent reductions in mortality among all parts of the study population: boys and girls from households with different socioeconomic backgrounds, among different ethnic groups, and across the children's age groups," Gortmaker said. "Given concerns about households and children being able to adhere to these regimens, this is reassuring news." --Misia Landau