Clinical Characteristics and Lung Function in Older Children Vertically Infected With Human Immunodeficiency Virus in Malawi.

摘要: Background. Antiretroviral therapy (ART) has led to increased survival of children with vertically acquired human immunodeficiency virus infection. Significant morbidity arises from respiratory symptoms, but aetiology and pulmonary function abnormalities have not been systematically studied. Methods. Human virus-positive aged 8–16 years were recruited within clinics in Blantyre, Malawi. Clinical review, quality life assessment, spirometry, chest radiography performed. Results. One hundred sixty participants had a mean age 11.1 (range, 8–16) 50.0% female. Cough was present 60 (37.5%) participants, 55 (34.4%) moderate or severe dyspnoea. Thirty-four (22.1%) digital clubbing. Thirty-three (20.6%) hypoxic at rest. eighteen (73.8%) the receiving ART; median CD4 count 698 cells/µL these compared 406 ART-naive individuals (P< .001). From 145 spirometry traces (90.6%), forced expiratory volume 1 second (FEV1) vital capacity (FVC) 1.06 0.89 standard deviations below predicted mean, respectively. Twenty-one (14.5%) demonstrated obstructive defects 26 (17.9%) reduced FVC. Lung abnormality associated any clinical findings. Of 51 abnormal lung function, increase FEV1 after salbutamol 3.8% (95% confidence interval, 0.02–7.53). “Tramlines” ring shadows seen on radiographs over half cases. Conclusions. Symptoms chronic disease highly prevalent 2 main phenotypes: “cough” “hypoxia”. are common, poorly responsive bronchodilators, apparent throughout range our cohort. Pathological causes remain be elucidated. phenotypes could useful part diagnostic algorithms if further validated.