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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Chronic lung disease in adolescents with delayed diagnosis of vertically acquired HIV infection
Clinical Infectious Diseases, Volume 55, No. 1, Year 2012
Notification
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Description
Background. Long-term survivors of vertically acquired human immunodeficiency virus (HIV) infection are reaching adolescence in large numbers in Africa and are at high risk of delayed diagnosis and chronic complications of untreated HIV infection. Chronic respiratory symptoms are more common than would be anticipated based on the HIV literature.Methods.Consecutive adolescents with presumed vertically acquired HIV attending 2 HIV care clinics in Harare, Zimbabwe, were recruited and assessed with clinical history and examination, CD4 count, pulmonary function tests, Doppler echocardiography, and chest radiography (CXR). Those with suspected nontuberculous chronic lung disease (CLD) were scanned using high-resolution computed tomography (HRCT).Results.Of 116 participants (43 male; mean age, 14 ± 2.6 years, mean age at HIV diagnosis, 12 years), 69 were receiving antiretroviral therapy. Chronic cough and reduced exercise tolerance were reported by 66 and 21 of participants, respectively; 41 reported multiple respiratory tract infections in the previous year, and 10 were clubbed. More than 40 had hypoxemia at rest (13) or on exercise (29), with pulmonary hypertension (mean pulmonary artery pressure >25 mm Hg) in 7. Forced expiratory volume in 1 second (FEV1) was <80 predicted in 45, and 47 had subtle CXR abnormalities. The predominant HRCT pattern was decreased attenuation as part of a mosaic attenuation pattern (31 of 56 [55]), consistent with small airway disease and associated with bronchiectasis (Spearman correlation coefficient (r2 = 0.8) and reduced FEV1 (r2 =-0.26).Conclusions.Long-term survivors of vertically acquired HIV in Africa are at high risk of a previously undescribed small airway disease, with >40 of unselected adolescent clinic attendees meeting criteria for severe hypoxic CLD. This condition is not obvious at rest. Etiology, prognosis, and response to treatment are currently unknown. © 2012 The Author.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3369563/bin/supp_55_1_145__index.html
https://efashare.b-cdn.net/share/pmc/articles/PMC3369563/bin/supp_cis271_cis271supp.doc
Authors & Co-Authors
Ferrand, Rashida Abbas
Unknown Affiliation
Desai, Sujal R.
Unknown Affiliation
Hopkins, Charlotte
Unknown Affiliation
Elston, Caroline M.
Unknown Affiliation
Copley, Susan Jennifer
Unknown Affiliation
Nathoo, Kusum Jackison
Unknown Affiliation
Ndhlovu, Chiratidzo Ellen
Unknown Affiliation
Munyati, Shungu S.
Unknown Affiliation
Barker, Richard D.
Unknown Affiliation
Miller, Robert F.
Unknown Affiliation
Bandason, Tsitsi
Unknown Affiliation
Wells, Athol U.
Unknown Affiliation
Corbett, Elizabeth L.
Unknown Affiliation
Statistics
Citations: 112
Authors: 13
Affiliations: 10
Identifiers
Doi:
10.1093/cid/cis271
ISSN:
10584838
e-ISSN:
15376591
Research Areas
Health System And Policy
Infectious Diseases
Noncommunicable Diseases
Study Locations
Zimbabwe
Participants Gender
Male