The chest X-ray features of chronic respiratory disease in HIV-infected children--a review.
Several features of human immunodeficiency virus (HIV) infection contribute to the development of chronic respiratory disease in children. These include the frequency and severity of acute chest infections, as well as the increased risk of pulmonary tuberculosis, aspiration, cardiovascular disease, lymphocytic interstitial pneumonitis or pulmonary neoplasia. The chest radiograph (CXR) remains the most accessible investigation for respiratory disease and plays an important role in the baseline assessment and follow-up. This review focuses on the CXR abnormalities of HIV-related chronic respiratory disease in children. The most commonly documented chronic CXR abnormalities are homogeneous opacification and pulmonary nodules, with pulmonary tuberculosis and lymphocytic interstitial pneumonitis the leading respective causes. Deficiencies in radiographic reporting methodology and relative paucity of radiographic data contribute to current limitations in knowledge and understanding of this field. The review highlights the need for standardised terminology and systematic reporting methodology in future studies. Prospective research on the natural history of lymphocytic interstitial pneumonitis, response to anti-tuberculous therapy, the impact of anti-retroviral therapy and HIV-associated bronchiectasis are needed.
Division of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa. Electronic address: pitcher@sun.ac.za.
Richard D
RD
Pitcher
Division of Radiology, Department of Radiation Medicine, New Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.
Stephen J
SJ
Beningfield
Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
Heather J
HJ
Zar
D002648:Child; D002908:Chronic Disease; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000150:complications / Q000000981:diagnostic imaging*; D008482:Mediastinum / Q000000981:diagnostic imaging; D055613:Multiple Pulmonary Nodules / Q000150:complications / Q000000981:diagnostic imaging*; D013902:Radiography, Thoracic; D012137:Respiratory System / Q000000981:diagnostic imaging; D012140:Respiratory Tract Diseases / Q000000981:diagnostic imaging; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging*
Chest X-ray; Children; Chronic respiratory disease; HIV-infection