McHugh, Grace; Rehman, Andrea M; Simms, Victoria; Gonzalez-Martinez, Carmen; Bandason, Tsitsi; Dauya, Ethel; Moyo, Brewster; Mujuru, Hilda; Rylance, Jamie; Sovershaeva, Evgeniya; +5 more... Weiss, Helen A; Kranzer, Katharina; Odland, Jon; Ferrand, Rashida A; BREATHE Clinical Trial Team; (2020) Chronic lung disease in children and adolescents with HIV: a case-control study. Tropical medicine & international health : TM & IH, 25 (5). ISSN 1360-2276 DOI: https://doi.org/10.1111/tmi.13375
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Abstract
OBJECTIVE: To describe the features of HIV-associated chronic lung disease (CLD) in older children and adolescents living with HIV and to examine the clinical factors associated with CLD. This is a post hoc analysis of baseline data from the BREATHE clinical trial (ClinicalTrials.gov, NCT02426112). METHODS: Children and adolescents aged 6-19 years were screened for CLD (defined as a FEV1 z-score <-1 with no reversibility post-bronchodilation with salbutamol) at two HIV clinics in Harare, Zimbabwe, and Blantyre, Malawi. Eligible participants with CLD (cases) were enrolled, together with a control group without CLD [frequency-matched by age group and duration on antiretroviral therapy (ART)] in a 4:1 allocation ratio. A clinical history and examination were undertaken. The association between CLD and a priori-defined demographic and clinical covariates was investigated using multivariable logistic regression. RESULTS: Of the 1585 participants screened, 419 (32%) had a FEV1 z-score <-1, of whom 347 were enrolled as cases [median age 15.3 years (IQR 12.7-17.7); 48.9% female] and 74 with FEV1 z-score >0 as controls [median age 15.6 years (IQR 12.1-18.2); 62.2% female]. Among cases, current respiratory symptoms including cough and shortness of breath were reported infrequently (9.3% and 1.8%, respectively). However, 152 (43.8%) of cases had a respiratory rate above the 90th centile for their age. Wasting and taking second-line ART were independently associated with CLD. CONCLUSIONS: The presence of CLD indicates the need to address additional treatment support for youth living with HIV, alongside ART provision, to ensure a healthier adulthood.
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Description: Added by Dr Andrea Rehman in a redeposit operation from Symplectic Elements.
Licence: Creative Commons: Attribution-Noncommercial-No Derivative Works 3.0
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