Children who acquired HIV perinatally are living longer, thanks to protease inhibitor therapy, but there's been little information on the quality of the lives of these children. In order to assess the effects of protease inhibitors on children's health, their growth, and the quality of their lives, researchers evaluated 940 children with perinatally acquired HIV and interviewed their primary caregivers.

The children ranged in age from eight to 15 years, most were black or Hispanic, most were small for their age, and more than half had a primary caregiver who was not the biological parent. Almost three-quarters of the children were undergoing protease inhibitor therapy, which often also included a nucleoside reverse transcriptase inhibitor or a nonnucleoside reverse transcriptase inhibitor. Most of the remaining children were receiving antiretroviral therapy without a protease inhibitor.

Those undergoing protease inhibitor therapy tended to be older and to have lower CD4+ cell counts, indicating that their HIV status might be more advanced. Most of the children perceived their health as being good, although in almost half physical activity was limited, and in nearly 60% social functioning or performance in school was somewhat limited. Although the incidence of diarrhea in the children undergoing protease inhibitor therapy was higher, quality-of-life scores overall weren't different from scores among those receiving other medications. Lead author Storm says that nursing interventions are needed to help alleviate disease symptoms, behavioral problems, and limitations on school and social functioning.

Storm DS, et al., for the Pediatric AIDS Clinical Trials Group Protocol 219 Study Team. Pediatrics 2005;115(2): e173-82. Epub 2005 Jan 3.