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Clinical features and lung function in HIV-infected children with chronic lung disease

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posted on 2023-05-18, 13:34 authored by Heinrich WeberHeinrich Weber, Gie, RP, Karen WillsKaren Wills, Cotton, MF

Background: Although chronic lung disease (CLD) is commonly seen in children with advanced HIV disease, it is poorly studied.

Objectives: To report on the clinical manifestations and lung function tests in children with advanced HIV disease at a tertiary care centre, and determine clinical predictors of poor lung function.

Methods: We undertook a cross-sectional study of children with advanced HIV disease in whom CLD was suspected. We undertook clinical evaluation and lung function tests, accompanied by a retrospective chart review.


In 56 children identified, the median age was 5 (interquartile range (IQR) 2 - 8) years with equal gender ratio. The majority (93%) had been previously treated for tuberculosis and/or pneumonia (71%). The most common CLD identified was lymphocytic interstitial pneumonitis (54%). The median nadir CD4 percentage was 13% (IQR 8.5 - 16%) and the median highest reported viral load was log5.8 (IQR log5.0 - log6.5). The median duration of antiretroviral therapy was 9.8 (IQR 1.1 - 19.5) months. Lung function tests were performed in 27 (48%) children. The median forced expiratory volume in 1 second (FEV1) was 60% (IQR 45.3 - 86.3%) predicted. Previous hospitalisation, respiratory rate, digital clubbing, chest hyperinflation and hyperpigmented skin lesions were associated with a decreased FEV1 in a univariate relationship. In a multiple linear regression analysis, hyperinflation, increased respiratory rate and hyperpigmented skin lesions were associated with poor lung function (percentage FEV1).

Conclusion: We identified useful clinical signs predictive of poor lung function in HIV-infected children with CLD, especially in resourcelimited settings.


Publication title

South African Journal of Child Health








Tasmanian School of Medicine


Health and Medical Publishing Group

Place of publication

South Africa

Rights statement

© 2014 Health & Medical Publishing Group. Licensed under Creative Commons Attribution-NonCommercial 3.0 Unported (CC BY-NC 3.0)

Repository Status

  • Open

Socio-economic Objectives

Clinical health not elsewhere classified

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