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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