Abstract
Background: Over 90% of HIV infected adolescents live in Sub-Saharan Africa. Although lung disease is very common, there is limited information on the spectrum of lung function impairment in HIV-infected adolescents.
Objective: To investigate lung function in South African HIV infected adolescents on antiretroviral therapy (ART) enrolled in a prospective cohort, the Cape Town Adolescent Anti-retroviral cohort.
Methods: Adolescents aged 9 to 14 years, stable on ART for at least 6 months, underwent baseline lung function testing. Lung function measures included spirometry, Nitrogen multiple breath wash out, forced oscillation technique and single breath carbon monoxide diffusion testing.A sample of HIV negative, age, sex and ethnically matched controls were also tested.
Results: 520 HIV-infected adolescents and 110 HIV negative controls were tested. The mean (SD) age in years was 12 (1.6) ; 52% were male. Median duration of ART therapy was 7.6 years. Median CD4 was 510.5 cells/mm3. Median HIV viral load was 226 copies/ml.
| Lung function measure | HIV infected | HIV uninfected | P value* |
| FEV1 (l) | 1.6 (1.3-1.9) | 1.8 (1.5-2.2) | 0.001 |
| FEV1/FVC (%) | 89 (85-95) | 93 (90-98) | <0.001 |
| Transfer factor for carbon monoxide (mlCO/min/mmHg) | 16.2 (14.1-18.7) | 17.6 (14.8-20.9) | 0.052 |
| Functional residual capacity (l) | 1.0 (0.8-1.2) | 1.2 (0.9-1.5) | 0.003 |
| Lung clearnce index | 7.4 (6.8-8.1) | 6.9 (6.3-7.6) | 0.008 |
| Resistance at 8Hz (cmH20.L/s) | 5.0 (4.2-5.7) | 4.4 (3.5-5.4) | 0.001 |
*adjusted for HIV status, age, height, gender
Conclusion: Lung function abnormalities are common in HIV-infected adolescents. African HIV infected adolescents on ART have lower lung function than HIV uninfected adolescents.
- Copyright ©the authors 2016
