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ObjectiveRespiratory disease is a major cause of morbidity and mortality in HIV-infected children. Despite antiretroviral therapy (ART), children suffer chronic symptoms. We investigated symptom prevalence, lung function and exercise capacity among older children established on ART and an age-matched HIV-uninfected group.DesignA cross-sectional study in Zimbabwe of HIV-infected children aged 6-16 years receiving ART for over 6 months and HIV-uninfected children attending primary health clinics from the same area.MethodsStandardized questionnaire, spirometry, incremental shuttle walk testing, CD4 cell count, HIV viral load and sputum culture for tuberculosis were performed.ResultsA total of 202 HIV-infected and 150 uninfected participants (median age 11.1 years in each group) were recruited. Median age at HIV diagnosis and ART initiation was 5.5 (interquartile range 2.8-7.5) and 6.1 (interquartile range 3.6-8.4) years, respectively. Median CD4 cell count was 726 cells/μl, and 79% had HIV viral load less than 400 copies/ml. Chronic respiratory symptoms were rare in HIV-uninfected children [n = 1 (0.7%)], but common in HIV-infected participants [51 (25%)], especially cough [30 (15%)] and dyspnoea [30 (15%)]. HIV-infected participants were more commonly previously treated for tuberculosis [76 (38%) vs 1 (0.7%), P ConclusionIn children, despite ART, HIV is associated with significant respiratory symptoms and functional impairment. Understanding pathogenesis is key, as new treatment strategies are urgently required.

Original publication

DOI

10.1097/qad.0000000000001249

Type

Journal article

Journal

AIDS (London, England)

Publication Date

11/2016

Volume

30

Pages

2795 - 2803

Addresses

aLiverpool School of Tropical Medicine, Liverpool, UK bBiomedical Research and Training Institute, Harare, Zimbabwe cUniversity of California, San Francisco, San Francisco, California, USA dUniversity of Zimbabwe, Harare, Zimbabwe eUniversity of Oxford, Oxford fLondon School of Hygiene and Tropical Medicine gRoyal Free Hospital, London, UK.

Keywords

Humans, HIV Infections, Lung Diseases, Chronic Disease, Anti-Retroviral Agents, Spirometry, CD4 Lymphocyte Count, Exercise, Viral Load, Cross-Sectional Studies, Adolescent, Child, Zimbabwe, Female, Male, Surveys and Questionnaires