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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.

Results:

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.

History

Publication title

South African Journal of Child Health

Volume

9

Pagination

72-75

ISSN

1994-3032

Department/School

Tasmanian School of Medicine

Publisher

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) http://creativecommons.org/licenses/by-nc/3.0/

Repository Status

  • Open

Socio-economic Objectives

Clinical health not elsewhere classified

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