title: Lung Function in South African Adolescents Infected Perinatally with HIV and Treated Long-Term with Antiretroviral Therapy.
abstract: BACKGROUND
  Lung disease is a common cause of mortality and morbidity in HIV-infected adolescents, but there is limited information on the spectrum of lung function impairment in adolescents on antiretroviral therapy.
  
  
  OBJECTIVE
  To investigate lung function in HIV-infected adolescents on antiretroviral therapy in the Cape Town Adolescent Antiretroviral Cohort (Cape Town, South Africa).
  
  
  METHODS
  A total of 515 South African adolescents, aged 9-14 years, stable on antiretroviral therapy for at least 6 months, underwent baseline lung function testing. Measures included spirometry, nitrogen multiple-breath washout, forced oscillation technique, 6-minute walk test, single-breath carbon monoxide diffusion testing, and bronchodilator response testing. A comparator group of 110 age- and ethnicity-matched HIV-uninfected adolescents was also tested.
  
  
  RESULTS
  For the HIV-infected adolescents (mean [SD] age 12 [1.6] years, 52% male), the median (interquartile range) duration of antiretroviral therapy was 7.6 (4.6-9.2) years. The median (interquartile range) nadir CD4 was 510.5 (274-903) cells/mm3. HIV-infected adolescents had significantly lower FEV1, FVC, FEV1/FVC, diffusing capacity of carbon monoxide, respiratory system compliance, and functional residual capacity than HIV-uninfected adolescents (P < 0.05 for all associations). HIV-infected adolescents had higher airway resistance and lung clearance index than HIV-uninfected adolescents (P < 0.05 for all associations). Although generally small in magnitude, these differences remained significant after adjusting for age, sex, and height. In addition, age, sex, height, and history of past lower respiratory tract infection or pulmonary tuberculosis were associated with reduced lung function.
  
  
  CONCLUSIONS
  Perinatally infected South African HIV-infected adolescents on antiretroviral therapy have lower lung function than uninfected adolescents. Prior lower respiratory tract infection or pulmonary tuberculosis is associated with lower lung function.
authors.affiliation: 1 Department of Pediatrics and Child Health, Red Cross Children's Hospital and Medical Research Council Unit, Child and Adolescent Health, and.
authors.forename: Leah Nyawira
authors.identifier: http://orcid.org/0000-0003-0480-0868
authors.initials: LN
authors.lastname: Githinji
authors.affiliation: 1 Department of Pediatrics and Child Health, Red Cross Children's Hospital and Medical Research Council Unit, Child and Adolescent Health, and.
authors.forename: Diane M
authors.initials: DM
authors.lastname: Gray
authors.affiliation: 1 Department of Pediatrics and Child Health, Red Cross Children's Hospital and Medical Research Council Unit, Child and Adolescent Health, and.
authors.forename: Sipho
authors.initials: S
authors.lastname: Hlengwa
authors.affiliation: 2 Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Landon
authors.initials: L
authors.lastname: Myer
authors.affiliation: 1 Department of Pediatrics and Child Health, Red Cross Children's Hospital and Medical Research Council Unit, Child and Adolescent Health, and.
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Zar
mesh_terms: D000293:Adolescent; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D001944:Breath Tests; D002248:Carbon Monoxide / Q000032:analysis; D002648:Child; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D016014:Linear Models; D008134:Long-Term Care; D008137:Longitudinal Studies; D008168:Lung / Q000503:physiopathology*; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D012129:Respiratory Function Tests; D013019:South Africa; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000503:physiopathology*; D000070857:Walk Test
chemical_list: D044966:Anti-Retroviral Agents; D002248:Carbon Monoxide
keywords: HIV; adolescent; lung function