Chest radiography patterns in 75 adolescents with vertically-acquired human immunodeficiency virus (HIV) infection


Desai, SR; Copley, SJ; Barker, RD; Elston, CM; Miller, RF; Wells, AU; Munyati, S; Nathoo, K; Corbett, EL; Ferrand, RA; (2011) Chest radiography patterns in 75 adolescents with vertically-acquired human immunodeficiency virus (HIV) infection. Clinical radiology, 66 (3). pp. 257-263. ISSN 0009-9260 DOI: https://doi.org/10.1016/j.crad.2010.10.009

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Abstract

AIM: To evaluate lung disease on chest radiography (CR), the relative frequency of CR abnormalities, and their clinical correlates in adolescents with vertically-acquired human immunodeficiency virus (HIV) infection. MATERIALS AND METHODS: CRs of 75 patients [59 inpatients (33 males; mean age 13.7 +/- 2.3 years) and 16 outpatients (eight males; mean age 14.1 +/- 2.1 years)] were retrospectively reviewed by three independent observers. The overall extent of disease (to the nearest 5%), its distribution, and the proportional extents (totalling 100%) of different radiographic patterns (including ring/tramline opacities and consolidation) were quantified. CR features and clinical data were compared. RESULTS: CRs were abnormal in 51/75 (68%) with "extensive" disease in 38/51 (74%). Ring/tramline opacities and consolidation predominated (i.e., proportional extent > 50%) in 26 and 21 patients, respectively. Consolidation was significantly more common in patients hospitalized primarily for a respiratory illness than patients hospitalized for a non-respiratory illness or in outpatients (p < 0.005, chi(2) for trend); by contrast, ring/tramline opacities did not differ in prevalence across the groups. On stepwise logistic regression, predominant consolidation was associated with progressive dyspnoea [odds ratio (OR) 5.60; 95% confidence intervals (CI): 1.60, 20.1; p < 0.01] and was associated with a primary respiratory cause for hospital admission (OR: 22.0; CI: 2.7, 181.1; p < 0.005). Ring/tramline opacities were equally prevalent in patients with and without chronic symptoms and in those admitted to hospital with respiratory and non-respiratory illness. CONCLUSION: In HIV-infected adolescents, evaluated in secondary practice, CR abnormalities are prevalent. The presence of ring/tramline opacities, believed to reflect chronic airway disease, is not linked chronic respiratory symptoms. (C) 2010 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Item Type: Article
Keywords: CHRONIC LUNG-DISEASE, OLDER CHILDREN, BRONCHIECTASIS, AIDS, PERSISTENT, MORTALITY, QUALITY, AFRICA
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
PubMed ID: 21295205
Web of Science ID: 287838800006
URI: http://researchonline.lshtm.ac.uk/id/eprint/1152

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