Chronic lung disease in children and adolescents with HIV: a case-control study.

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  • Additional Information
    • Affiliation:
      Biomedical Research and Training Institute, Harare, Zimbabwe
      MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
      Malawi‐Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
      Department of Paediatrics, University of Zimbabwe, Harare, Zimbabwe
      Arctic University of Norway, Tromsø, Norway
      National TB Reference Laboratory, Research Centre Borstel, Borstel, Germany
      Clinical Research Unit, London School of Hygiene and Tropical Medicine, London, UK
      Norwegian University of Science and Technology, Trondheim, Norway
    • Corporate Authors:
    • Abstract:
      Objective: To describe the features of HIV-associated chronic lung disease (CLD) in older children and adolescents living with HIV and to examine the clinical factors associated with CLD. This is a post hoc analysis of baseline data from the BREATHE clinical trial (ClinicalTrials.gov, NCT02426112).Methods: Children and adolescents aged 6-19 years were screened for CLD (defined as a FEV1 z-score <-1 with no reversibility post-bronchodilation with salbutamol) at two HIV clinics in Harare, Zimbabwe, and Blantyre, Malawi. Eligible participants with CLD (cases) were enrolled, together with a control group without CLD [frequency-matched by age group and duration on antiretroviral therapy (ART)] in a 4:1 allocation ratio. A clinical history and examination were undertaken. The association between CLD and a priori-defined demographic and clinical covariates was investigated using multivariable logistic regression.Results: Of the 1585 participants screened, 419 (32%) had a FEV1 z-score <-1, of whom 347 were enrolled as cases [median age 15.3 years (IQR 12.7-17.7); 48.9% female] and 74 with FEV1 z-score >0 as controls [median age 15.6 years (IQR 12.1-18.2); 62.2% female]. Among cases, current respiratory symptoms including cough and shortness of breath were reported infrequently (9.3% and 1.8%, respectively). However, 152 (43.8%) of cases had a respiratory rate above the 90th centile for their age. Wasting and taking second-line ART were independently associated with CLD.Conclusions: The presence of CLD indicates the need to address additional treatment support for youth living with HIV, alongside ART provision, to ensure a healthier adulthood.
      Objectif: Décrire les caractéristiques de la maladie pulmonaire chronique (MPC) associée au VIH chez les enfants plus âgés et les adolescents vivant avec le VIH et examiner les facteurs cliniques associés à la MPC. Il s'agit d'une analyse post‐hoc des données de référence de l'essai clinique BREATHE (ClinicalTrials.gov, NCT02426112). Méthodes: Les enfants et adolescents âgés de 6 à 19 ans ont été dépistés pour la MPC (défini comme un score z FEV1 <‐1 sans réversibilité post‐bronchodilatation avec du salbutamol) dans deux cliniques VIH à Harare, au Zimbabwe et à Blantyre, au Malawi. Les participants éligibles atteints de MPC (cas) ont été inscrits, ainsi qu'un groupe témoin sans MPC (fréquence appariée par groupe d'âge et durée sous ART) dans un rapport d'allocation de 4:1. Une histoire clinique et un examen ont été entrepris. L'association entre la MPC et les covariables démographiques et cliniques définies a priori a été étudiée en utilisant une régression logistique multivariable. Résultats: Sur les 1.585 participants dépistés, 419 (32%) avaient un score z FEV 1 <‐1, dont 347 étaient inscrits comme cas (âge médian 15,3 ans [IQR 12,7 ‐17,7]; 48,9% de sexe féminin), et 74 avec un score z FEV1 >0 comme témoins (âge médian 15,6 ans [IQR 12,1 ‐18,2]; 62,2% de sexe féminin). Parmi les cas, les symptômes respiratoires en cours, y compris la toux et l'essoufflement, n'ont pas été rapportés fréquemment (9,3% et 1,8%, respectivement). Cependant, 152 (43,8%) des cas avaient une fréquence respiratoire supérieure au 90e centile pour leur âge. L'émaciation et la prise d'un traitement antirétroviral (ART) de deuxième intention étaient indépendamment associées à la MPC. Conclusions: La présence de MPC indique la nécessité d'un soutien thérapeutique supplémentaire aux jeunes vivant avec le VIH, à côté de à la fourniture de l'ART, pour assurer un âge adulte en meilleure santé.
    • Journal Subset:
      Biomedical; Europe; UK & Ireland
    • ISSN:
      1360-2276
    • MEDLINE Info:
      PMID: NLM31989731 NLM UID: 9610576
    • Grant Information:
      MR/R010161/1/MRC_/Medical Research Council/United Kingdom; 206316/Z/17/Z/WT_/Wellcome Trust/United Kingdom; //Global Health and Vaccination Research (GLOBVAC) Programme of the Medical Research Council of Norway/
    • Publication Date:
      In Process
    • Publication Date:
      20200716
    • DOI:
      http://dx.doi.org/10.1111/tmi.13375
    • Accession Number:
      143197604
  • Citations
    • ABNT:
      MCHUGH, G. et al. Chronic lung disease in children and adolescents with HIV: a case-control study. Tropical Medicine & International Health, [s. l.], v. 25, n. 5, p. 590–599, 2020. DOI 10.1111/tmi.13375. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143197604. Acesso em: 10 ago. 2020.
    • AMA:
      McHugh G, Rehman AM, Simms V, et al. Chronic lung disease in children and adolescents with HIV: a case-control study. Tropical Medicine & International Health. 2020;25(5):590-599. doi:10.1111/tmi.13375
    • APA:
      McHugh, G., Rehman, A. M., Simms, V., Gonzalez, M. C., Bandason, T., Dauya, E., Moyo, B., Mujuru, H., Rylance, J., Sovershaeva, E., Weiss, H. A., Kranzer, K., Odland, J., Ferrand, R. A., Corbett, E. L., Flaegstad, T., Gutteberg, T. J., Cavanagh, J. P., Majonga, E., & Dube, F. (2020). Chronic lung disease in children and adolescents with HIV: a case-control study. Tropical Medicine & International Health, 25(5), 590–599. https://doi.org/10.1111/tmi.13375
    • Chicago/Turabian: Author-Date:
      McHugh, Grace, Andrea M. Rehman, Victoria Simms, Martinez, Carmen Gonzalez, Tsitsi Bandason, Ethel Dauya, Brewster Moyo, et al. 2020. “Chronic Lung Disease in Children and Adolescents with HIV: A Case-Control Study.” Tropical Medicine & International Health 25 (5): 590–99. doi:10.1111/tmi.13375.
    • Harvard:
      McHugh, G. et al. (2020) ‘Chronic lung disease in children and adolescents with HIV: a case-control study’, Tropical Medicine & International Health, 25(5), pp. 590–599. doi: 10.1111/tmi.13375.
    • Harvard: Australian:
      McHugh, G, Rehman, AM, Simms, V, Gonzalez, MC, Bandason, T, Dauya, E, Moyo, B, Mujuru, H, Rylance, J, Sovershaeva, E, Weiss, HA, Kranzer, K, Odland, J, Ferrand, RA, Corbett, EL, Flaegstad, T, Gutteberg, TJ, Cavanagh, JP, Majonga, E & Dube, F 2020, ‘Chronic lung disease in children and adolescents with HIV: a case-control study’, Tropical Medicine & International Health, vol. 25, no. 5, pp. 590–599, viewed 10 August 2020, .
    • MLA:
      McHugh, Grace, et al. “Chronic Lung Disease in Children and Adolescents with HIV: A Case-Control Study.” Tropical Medicine & International Health, vol. 25, no. 5, May 2020, pp. 590–599. EBSCOhost, doi:10.1111/tmi.13375.
    • Chicago/Turabian: Humanities:
      McHugh, Grace, Andrea M. Rehman, Victoria Simms, Martinez, Carmen Gonzalez, Tsitsi Bandason, Ethel Dauya, Brewster Moyo, et al. “Chronic Lung Disease in Children and Adolescents with HIV: A Case-Control Study.” Tropical Medicine & International Health 25, no. 5 (May 2020): 590–99. doi:10.1111/tmi.13375.
    • Vancouver/ICMJE:
      McHugh G, Rehman AM, Simms V, Gonzalez MC, Bandason T, Dauya E, et al. Chronic lung disease in children and adolescents with HIV: a case-control study. Tropical Medicine & International Health [Internet]. 2020 May [cited 2020 Aug 10];25(5):590–9. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143197604