I think this is an example of what shouldbe done with every antiretroviral drug. The National Pediatric HIV Resource Center is currently working on new guidelines, but when they held a meeting in July of 1996, most researchers still wanted to recommend ddI monotherapy as the treatment of choice. Within the past three months, more researchers are agreeing that we need to treat early and aggressively. Once this document is finished and published, the standard of care hopefully will include combination therapy for children with HIV infection. The recent success in preventing transmission of HIV from mother to child, however, may be only further propagating complacency in government-sponsored pediatric AIDS research.
Adolescents are still the highest risk group for new infection.
This falls under pediatric research. Dr. Ammann says that we will need a shift in emphasis to what we will do internationally. This raises some important questions ethically about how we'll intervene internationally to conduct pediatric AIDS research. Still, he points out, there are reasons to maintain a strong pediatric research effort. Some research questions, he suggests, could optimally be answered in children.