Chronic lung disease in HIV-infected children established on antiretroviral therapy
Respiratory disease is a major cause of morbidity and mortality in HIV-infected children. Despite antiretroviral therapy (ART), children suffer chronic symptoms. We investigated symptom prevalence, lung function, and exercise capacity among older children established on ART, and an age-matched HIV-u...
| Main Authors: | , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Lippincott, Williams & Wilkins
2016
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| _version_ | 1797096292207296512 |
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| author | Rylance, J Mchugh, G Metcalfe, J Mujuru, H Nathoo, K Wilmore, S Rowland-Jones, S Majonga, E Kranzer, K Ferrand, R |
| author_facet | Rylance, J Mchugh, G Metcalfe, J Mujuru, H Nathoo, K Wilmore, S Rowland-Jones, S Majonga, E Kranzer, K Ferrand, R |
| author_sort | Rylance, J |
| collection | OXFORD |
| description | Respiratory disease is a major cause of morbidity and mortality in HIV-infected children. Despite antiretroviral therapy (ART), children suffer chronic symptoms. We investigated symptom prevalence, lung function, and exercise capacity among older children established on ART, and an age-matched HIV-uninfected group.A cross-sectional study in Zimbabwe of: 1) HIV-infected children aged 6-16 years receiving ART for over six months; 2) HIV-uninfected children attending primary health clinics from the same area.Standardised questionnaire, spirometry, Incremental Shuttle Walk Testing (ISWT), CD4 count, HIV viral load, and sputum culture for tuberculosis were performed.202 HIV-infected and 150 uninfected participants (median age 11.1 years in each group) were recruited. Median age at HIV diagnosis and ART initiation was 5.5 (IQR 2.8-7.5) and 6.1 years (IQR 3.6-8.4) respectively. Median CD4 count was 726 cells/μl, and 79% had HIV viral load<400copies/ml. Chronic respiratory symptoms were rare in HIV-uninfected children (n = 1 [0.7%]), but common in HIV-infected participants (51 [25%]), especially cough (30 [15%]) and dyspnoea (30 [15%]). HIV-infected participants were more commonly previously treated for tuberculosis (76 [38%] versus 1 [0.7%], p < 0.001), had lower exercise capacity (mean ISWT distance 771m versus 889m respectively, p < 0.001), and more frequently abnormal spirometry (43 [24.3%] versus 15 [11.5%], p = 0.003) compared to HIV-uninfected participants. HIV diagnosis at an older age was associated with lung function abnormality (p = 0.025). No participant tested positive for M. tuberculosis.In children, despite ART, HIV is associated with significant respiratory symptoms and functional impairment. Understanding pathogenesis is key, as new treatment strategies are urgently required. |
| first_indexed | 2024-03-07T04:39:48Z |
| format | Journal article |
| id | oxford-uuid:d1394599-68bc-42b5-8b7e-f3b4249cf8c3 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T04:39:48Z |
| publishDate | 2016 |
| publisher | Lippincott, Williams & Wilkins |
| record_format | dspace |
| spelling | oxford-uuid:d1394599-68bc-42b5-8b7e-f3b4249cf8c32022-03-27T07:55:35ZChronic lung disease in HIV-infected children established on antiretroviral therapyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:d1394599-68bc-42b5-8b7e-f3b4249cf8c3EnglishSymplectic Elements at OxfordLippincott, Williams & Wilkins2016Rylance, JMchugh, GMetcalfe, JMujuru, HNathoo, KWilmore, SRowland-Jones, SMajonga, EKranzer, KFerrand, RRespiratory disease is a major cause of morbidity and mortality in HIV-infected children. Despite antiretroviral therapy (ART), children suffer chronic symptoms. We investigated symptom prevalence, lung function, and exercise capacity among older children established on ART, and an age-matched HIV-uninfected group.A cross-sectional study in Zimbabwe of: 1) HIV-infected children aged 6-16 years receiving ART for over six months; 2) HIV-uninfected children attending primary health clinics from the same area.Standardised questionnaire, spirometry, Incremental Shuttle Walk Testing (ISWT), CD4 count, HIV viral load, and sputum culture for tuberculosis were performed.202 HIV-infected and 150 uninfected participants (median age 11.1 years in each group) were recruited. Median age at HIV diagnosis and ART initiation was 5.5 (IQR 2.8-7.5) and 6.1 years (IQR 3.6-8.4) respectively. Median CD4 count was 726 cells/μl, and 79% had HIV viral load<400copies/ml. Chronic respiratory symptoms were rare in HIV-uninfected children (n = 1 [0.7%]), but common in HIV-infected participants (51 [25%]), especially cough (30 [15%]) and dyspnoea (30 [15%]). HIV-infected participants were more commonly previously treated for tuberculosis (76 [38%] versus 1 [0.7%], p < 0.001), had lower exercise capacity (mean ISWT distance 771m versus 889m respectively, p < 0.001), and more frequently abnormal spirometry (43 [24.3%] versus 15 [11.5%], p = 0.003) compared to HIV-uninfected participants. HIV diagnosis at an older age was associated with lung function abnormality (p = 0.025). No participant tested positive for M. tuberculosis.In children, despite ART, HIV is associated with significant respiratory symptoms and functional impairment. Understanding pathogenesis is key, as new treatment strategies are urgently required. |
| spellingShingle | Rylance, J Mchugh, G Metcalfe, J Mujuru, H Nathoo, K Wilmore, S Rowland-Jones, S Majonga, E Kranzer, K Ferrand, R Chronic lung disease in HIV-infected children established on antiretroviral therapy |
| title | Chronic lung disease in HIV-infected children established on antiretroviral therapy |
| title_full | Chronic lung disease in HIV-infected children established on antiretroviral therapy |
| title_fullStr | Chronic lung disease in HIV-infected children established on antiretroviral therapy |
| title_full_unstemmed | Chronic lung disease in HIV-infected children established on antiretroviral therapy |
| title_short | Chronic lung disease in HIV-infected children established on antiretroviral therapy |
| title_sort | chronic lung disease in hiv infected children established on antiretroviral therapy |
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