Research

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

Heinrich Christoph Weber, Robert P Gie, Karen Wills, Mark Frederick Cotton

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 resource-limited settings.


Authors' affiliations

Heinrich Christoph Weber, Faculty of Health, School of Medicine, University of Tasmania, Burnie

Robert P Gie, Department of Paediatrics and Child Health, Stellenbosch University

Karen Wills, Menzies Research Institute, University of Tasmania, Hobart

Mark Frederick Cotton, KID-CRU Research Institute, Cape Town

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Keywords

HIV; HIV-infected children; chronic lung disease; lung function

Cite this article

South African Journal of Child Health 2015;9(3):72-75. DOI:10.7196/SAJCH.7940

Article History

Date submitted: 2014-04-29
Date published: 2015-09-23

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