405 HIV-Related Risk Factors for Asthma in Children

F. Gutin, E. Secord; Allergy/Immunology, Wayne State University/Chil-dren’s Hospital of Michigan, Detroit, MI.RATIONALE: To determine HIV-related risk factors for asthma diagno-sis and asthma exacerbations in children.METHODS: Children with HIV infection (perinatal) and Asthma, fol-lowed in Pediatric HIV Clinic, were prospectively evaluated over 6-monthperiod (2003). The charts of the same patients were reviewed for the peri-od of 24 months preceding the enrollment (2001-2002). HIV Viral Load(RNA PCR), CD4+ T-cells, and asthma exacerbations were recorded.RESULTS: 24/85 HIV infected children (age 3-16 years) had been pre-viously diagnosed with asthma. In 65% of patients, asthma was diagnosedwithin 3 years of starting highly active anti-retroviral therapy (HAART).In 22/24 patients CD4+ T-cells at the time of asthma diagnosis were avail-able for review, and all were within acceptable limits for age, i.e. recon-stituted after HIV therapy or never depleted at the time of asthma diagno-sis. The asthma severity increased in the group over the 30-month periodwith increase in the proportion of patients with mild persistent (from 21%to 58%) and moderate persistent asthma (from 4% to 8%). 63 asthmaexacerbations were recorded. There was no association between viral loadfluctuation and asthma exacerbations. Poor adherence to HIV medicationsdid not predict asthma exacerbation. CD4+ T-cells dropped transientlybelow the level recommended for PCP prophylaxis in 2 patients, and thedrop in each case coincided with improvement in asthma control.CONCLUSIONS: CD4+ T cell count was inversely correlated with riskof asthma diagnosis and exacerbation in this population. Viral Load fluc-tuation and adherence to HIV medications did not correlate with asthmaexacerbations.Funding: Self-funded

J ALLERGY CLIN IMMUNOL Abstracts S127VOLUME 113, NUMBER 2

SU

ND

AY