June 6, 2000

BIRMINGHAM, AL — Adolescents with HIV are able to withstand the ravages of the disease on the immune system much better than adults or younger children with the virus, according to a recent study by Dr. Craig Wilson and collaborators. Wilson is an associate professor of pediatrics with the University of Alabama at Birmingham (UAB). Details of the study were published in the April 2000 issue of the Archives of Pediatric and Adolescent Medicine.

"The rate of HIV infection among adolescents in the U.S. is increasing 200 to 300 percent each year," says Wilson. "Adolescents are the segment of the population in the U.S. that has not been well addressed, and it's now estimated that one-quarter to one-half of all new HIV infections occur in people under age 22."

Findings support the importance of early diagnosis and treatment of HIV in adolescents. "Available therapies don't wipe out the virus, but if we can keep the virus level low for an extended period of time, the immune system can recover, or reconstitute," says Wilson. "The study suggests that physicians should be even more aggressively treating adolescents with HIV because they have a better chance of coming back and potentially doing even better in the long run compared to adults," says Wilson.

The study measured the destruction and regeneration of CD4 and CD8 cells — particular types of immune system cells — in infected adolescents not on drug therapy. "The amount of destruction of CD4 and CD8 cells tells us best where someone is in terms of disease," says Wilson. "It appears that adolescents infected with the virus retain more CD8 cells than other age groups. So, we predict they would do better on therapy."

The study was conducted as part of a larger, multi-center national study, called Reaching for Excellence in Adolescent Care and Health (REACH), to gather basic information about HIV in adolescents infected through risky behaviors. "Adolescents have not been studied as extensively as other groups," says Wilson. "The information we are gathering will be used to develop interventions and prevention programs tailored to adolescents."

REACH is following a group of about 400 boys and girls between the ages of 12 and 18. Females represent about 75 percent of participants and about 90 percent are racial minorities. "This cohort reflects the emerging epidemic in adolescents," says Wilson. "By far, most new cases in adolescents are being diagnosed in minority females. And, like the epidemic worldwide, in the U.S., HIV is now predominantly a heterosexually acquired disease."

Wilson, clinical research director and vice-chair of the REACH study, runs the Data and Operations Center for REACH at UAB. The center coordinates the national study, and collects and analyzes the data. The five-year study will end in December. "By then, we believe we will have the basic information we need to move to the next stage of developing interventions and prevention programs," Wilson says.