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

Citation

Weber, HC and Gie, RP and Wills, K and Cotton, MF, Clinical features and lung function in HIV-infected children with chronic lung disease, South African Journal of Child Health, 9, (3) pp. 72-75. ISSN 1994-3032 (2015) [Refereed Article]


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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/

DOI: doi:10.7196/SAJCH.7940

Abstract

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.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Respiratory Diseases
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Respiratory System and Diseases (incl. Asthma)
UTAS Author:Weber, HC (Dr Heinrich Weber)
UTAS Author:Wills, K (Dr Karen Wills)
ID Code:103634
Year Published:2015
Deposited By:Menzies Institute for Medical Research
Deposited On:2015-10-21
Last Modified:2016-04-13
Downloads:102 View Download Statistics

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