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Table 2 Summary of studies on lung function in HIV-infected children and adolescents

From: Lung function in HIV-infected children and adolescents

Author, Journal

Symptoms

Study design &country

Participant characteristics

Lung function test

Summary of results

Desai et al. [5] 2017

Clin Infec Dis

−25% chronic cough

− 5% wheeze

−18% resting hypoxia

Cross-sectional,

Zimbabwe

HIV-infected adolescents, median age 11 years, n = 193, ART duration 5 years

Spirometry with BDR

-Mosaic attenuation and bronchiectasis on HRCT strongly correlated with FEV1, r = −0.52, and r = −0.50, p < 0.001 respectively.

Shearer et al. [20] 2017

J Allergy Clin & Immuno

−34% had history of physician-diagnosed asthma

Cohort,

USA

218 HIV-infected, all on ART; 152 HIV-uninfected exposed; median age 17 years

Spirometry with BDR

-Obstructive spirometry pattern similar in both groups (22% vs 21%).

−17% HIV-exposed uninfected youth had positive BDR vs 9% in HIV-infected youth, p = 0.052

Githinji et al. [12] 2017

Annals of ATS

−10% had history of asthma

−4% had clubbing

− 15% anytime cough

Cohort study, South Africa

515 HIV –infected adolescents, median age 12 years; mean ART duration 8 years, and 110 HIV-uninfected

Spirometry with BDR,

FOT, N2MBW, Single breath CO

6MWT

-Flow, volume, compliance, diffusion capacity lower in HIV-infected than uninfected; Higher resistance and LCI in HIV-infected compared to uninfected, p < 0.05

-No cardiorespiratory function impairment on exercise testing in both groups

Gray D. et al. [7] 2017

Thorax

Birth cohort

129 infants HIV-exposed uninfected; 546 infants born to HIV-uninfected mothers; median age 50 days

Tidal breathing and flow volume loops

-HIV-exposed infants had higher tidal volumes compared to infants born to HIV-uninfected mothers, p = 0.04

McHugh et al. [1] 2016

AIDS

−54% chronic cough

−16% reported dypnoea

Cross-sectional, Zimbabwe

385 HIV-infected children, median age 11 year, none on ART

Spirometry with BDR, shuttle walk test

−10% obstructive spirometry; 1.3% BDR

−18% reduced FVC

− 10% desaturated to < 88% on exercise

Rylance et al. [15] 2016

Arch dis child (poster abstract)

-Those receiving ART, 15% had dyspnea

−15% had daily cough

Cross-sectional

385 HIV-infected ART-naïve;202 on ART; median age 11 years

Spirometry

6MWT

-Proportion of abnormal spirometry similar in ART-exposed and ART-naïve group (25.6% vs 24.3%)

-Less distance in 6MWT in ART-naïve group, p < 0.001

Mwalukomo et al. [13] 2016

Peds Inf Dis

−8% had history of wheeze

− 22% had finger clubbing

− 20% had resting hypoxia

Cross-sectional, Malawi

160 HIV-infected; median age 11 years

71% on ART median duration 3.5 years

Spirometry with BDR

-18% obstructive spirometry, 20% reduced FVC; 32% had + BDR

Rylance et al. [16] 2016

AIDS

− 15% had chronic cough

− 15% had dyspnea

− 5% had wheeze

Cross-sectional, Zimbabwe

150 HIV-uninfected;202 HIV-infected;median age 11 years

ART mean duration 5 years

Spirometry with BDR,

Shuttle walk test

-Lower FEV1, FVC, and FEF50 in HIV-infected, p < 0.05. 11 (35%) out of 31 with obstructive spirometry had + BDR

-Less distance walked in HIV-infected, p < 0.001

Chisati et al. [17] 2015

Malawi Med. Journal

Cross-sectional, Malawi

55 HIV-infected youth, not on ART and 78 uninfected youth, mean age 24 years

Treadmill exercise test

-Lower VO2max (aerobic endurance) in HIV-infected compared to uninfected, p = 0.01

Masekela et al. [14] 2012

Int J Tuberc Lung Dis

Cross-sectional, South Africa

35, 6-18y with HIV-related bronchiectasis, all on ART

Spirometry with BDR

-Median FEV1 was 53%

Ferrand et al. [6] 2012

Clin Inf Dis

−35% resting hypoxia

−66% recurrent cough

− 10% clubbing

Cross sectional, Zimbabwe

116 adolescents mean age 14 years, vertically HIV-infected,

69% ART mean duration 20 months

Spirometry with BDR,

200 m brisk walk

-45% had FEV1 < 80%; 47% had CXR abnormalities, 55% had mosaic attenuation on HRCT

Samadi et al. 2012

(unpublished data)

Cross-sectional, South Africa

56 HIV infected on INH prophylaxis, 7-10y, none on ART

Spirometry with BDR

−21% had abnormal spirometry; 18% had positive BDR

Cade et al. [29] 2002

Ped Rehab

 

Cross-sectional, USA

15 HIV-infected adolescents,14 on ART &15 matched HIV-uninfected,

median age 18 years

Treadmill exercise test

-Peak oxygen consumption, treadmill duration and oxygen pulse were lower in HIV infected adolescents compared to uninfected, p < 0.05 for all

Colin A et al. [9] 2001

AJRCCM

Cohort, USA

285 HIV-exposed uninfected infants born to HIV-infected mothers, 92 HIV-unexposed uninfected infants

Vmax FRC by rapid thoracic compression

-Forced expiratory flow was ≈20% less in the HIV-exposed group but this difference was non-significant

Keyser et al. [30] 2000

Arch Phys Med Rehabil

Cross-sectional, USA

17 HIV-infected mean age 18 years; all on ART

treadmill exercise test

-Peak oxygen consumption was lower than expected (functional 2aerobic impairment)

Platzker et al. [8] 2000

AJRCCM

Cohort, USA

41 infants born to HIV-infected mothers (34% of infants HIV-infected), mean age 24 months

Thoraco-abdominal compression

-Respiratory system compliance reduced and declined more after TAC in HIV-infected, p = 0.003

-Higher resistance in HIV-infected infants compared to uninfected, p = 0.03

Alderson et al. [10] 1999 Radiology

Cohort, USA

132 HIV-infected children, mean age 47 months and 160 HIV-exposed uninfected infants; mean age 10 months

Lung diffusion capacity using 99mTc DTPA

-HIV-infected children had faster clearance of 99mTc DTPA compared to HIV-exposed uninfected children, p < 0.05, in the absence of clinical symptoms

De Martino et al. [11] 1997 Paeds Pulm

Prospective longitudinal cohort, Italy

54 children, median age 64 months, with perinatal HIV infection, none on ART and 315 healthy controls

Interrupter technique

-Airway resistance greater in HIV-infected than uninfected, p < 0.001

  1. +BDR Positive bronchodilator responsiveness in FEV1 > 12%, HEU-HIV-exposed uninfected, FEV 1 Forced expiratory volume in 1 s, FVC Forced vital capacity, FEF 2575 Forced expiratory flow between 25 and 75 s of vital capacity, 99mTc DTPA Diethylene triamine pentaacetic acid, 6MWT Six-minute walk test, FOT Forced oscillation technique, N 2 MBW Nitrogen multiple breath wash-out test, CO Carbon monoxide, HRCT High resolution chest tomography