Chronic lung disease in children and adolescents with HIV: a case–control study
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). M...
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| Veröffentlicht in: | Tropical medicine & international health 2020-05, Vol.25 (5), p.590-599 |
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| creator | McHugh, Grace Rehman, Andrea M. Simms, Victoria Gonzalez‐Martinez, Carmen Bandason, Tsitsi Dauya, Ethel Moyo, Brewster Mujuru, Hilda Rylance, Jamie Sovershaeva, Evgeniya Weiss, Helen A. Kranzer, Katharina Odland, Jon Ferrand, Rashida A. Corbett, Elizabeth L Flaegstad, Trond Gutteberg, Tore J Cavanagh, Jorunn Pauline Majonga, Edith Dube, Felix Mhbele, Slee Yindom, Louis‐Marie Rowland‐Jones, Sarah Nicol, Mark |
| description | 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 |
| doi_str_mv | 10.1111/tmi.13375 |
| format | Article |
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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.</description><identifier>ISSN: 1360-2276</identifier><identifier>EISSN: 1365-3156</identifier><identifier>DOI: 10.1111/tmi.13375</identifier><identifier>PMID: 31989731</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adolescents ; Africa ; Afrique ; Age ; Antiretroviral agents ; Antiretroviral therapy ; Bronchodilation ; Bronchodilators ; Case-Control Studies ; Child ; Child Health Services ; Children ; chronic lung disease ; Cough ; Female ; HIV ; HIV Infections ; HIV-1 ; Human immunodeficiency virus ; Humans ; Lung diseases ; Lung Diseases - complications ; Lung Diseases - epidemiology ; maladie pulmonaire chronique ; Malawi - epidemiology ; Male ; Regression analysis ; Respiration ; Respiratory rate ; Salbutamol ; Sexually transmitted diseases ; Signs and symptoms ; STD ; Surveys and Questionnaires ; Survivors ; Teenagers ; VIH ; Young Adult ; Youth ; Zimbabwe - epidemiology</subject><ispartof>Tropical medicine & international health, 2020-05, Vol.25 (5), p.590-599</ispartof><rights>2020 John Wiley & Sons Ltd</rights><rights>2020 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3555-ea460b849f48c9e3acdaa4e59d0d2d576326d6de9b8dcbf6a07c306bd01069573</citedby><cites>FETCH-LOGICAL-c3555-ea460b849f48c9e3acdaa4e59d0d2d576326d6de9b8dcbf6a07c306bd01069573</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Ftmi.13375$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Ftmi.13375$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,1432,27923,27924,45573,45574,46408,46832</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31989731$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>McHugh, Grace</creatorcontrib><creatorcontrib>Rehman, Andrea M.</creatorcontrib><creatorcontrib>Simms, Victoria</creatorcontrib><creatorcontrib>Gonzalez‐Martinez, Carmen</creatorcontrib><creatorcontrib>Bandason, Tsitsi</creatorcontrib><creatorcontrib>Dauya, Ethel</creatorcontrib><creatorcontrib>Moyo, Brewster</creatorcontrib><creatorcontrib>Mujuru, Hilda</creatorcontrib><creatorcontrib>Rylance, Jamie</creatorcontrib><creatorcontrib>Sovershaeva, Evgeniya</creatorcontrib><creatorcontrib>Weiss, Helen A.</creatorcontrib><creatorcontrib>Kranzer, Katharina</creatorcontrib><creatorcontrib>Odland, Jon</creatorcontrib><creatorcontrib>Ferrand, Rashida A.</creatorcontrib><creatorcontrib>Corbett, Elizabeth L</creatorcontrib><creatorcontrib>Flaegstad, Trond</creatorcontrib><creatorcontrib>Gutteberg, Tore J</creatorcontrib><creatorcontrib>Cavanagh, Jorunn Pauline</creatorcontrib><creatorcontrib>Majonga, Edith</creatorcontrib><creatorcontrib>Dube, Felix</creatorcontrib><creatorcontrib>Mhbele, Slee</creatorcontrib><creatorcontrib>Yindom, Louis‐Marie</creatorcontrib><creatorcontrib>Rowland‐Jones, Sarah</creatorcontrib><creatorcontrib>Nicol, Mark</creatorcontrib><creatorcontrib>BREATHE Clinical Trial Team</creatorcontrib><creatorcontrib>the BREATHE Clinical Trial Team</creatorcontrib><title>Chronic lung disease in children and adolescents with HIV: a case–control study</title><title>Tropical medicine & international health</title><addtitle>Trop Med Int Health</addtitle><description>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.</description><subject>Adolescent</subject><subject>Adolescents</subject><subject>Africa</subject><subject>Afrique</subject><subject>Age</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral therapy</subject><subject>Bronchodilation</subject><subject>Bronchodilators</subject><subject>Case-Control Studies</subject><subject>Child</subject><subject>Child Health Services</subject><subject>Children</subject><subject>chronic lung disease</subject><subject>Cough</subject><subject>Female</subject><subject>HIV</subject><subject>HIV Infections</subject><subject>HIV-1</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Lung diseases</subject><subject>Lung Diseases - complications</subject><subject>Lung Diseases - epidemiology</subject><subject>maladie pulmonaire chronique</subject><subject>Malawi - epidemiology</subject><subject>Male</subject><subject>Regression analysis</subject><subject>Respiration</subject><subject>Respiratory rate</subject><subject>Salbutamol</subject><subject>Sexually transmitted diseases</subject><subject>Signs and symptoms</subject><subject>STD</subject><subject>Surveys and Questionnaires</subject><subject>Survivors</subject><subject>Teenagers</subject><subject>VIH</subject><subject>Young Adult</subject><subject>Youth</subject><subject>Zimbabwe - epidemiology</subject><issn>1360-2276</issn><issn>1365-3156</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMFKwzAYgIMobk4PvoAEPHnoljRN2nqTMd1gIsL0GtIkdRldOpOWsZvv4Bv6JMZ1evO__P_h4_vhA-ASoyEOM2rWZogJSekR6GPCaEQwZcf7G0VxnLIeOPN-hRBKEspOQY_gPMtTgvvgebx0tTUSVq19g8p4LbyGxkK5NJVy2kJhFRSqrrSX2jYebk2zhNPZ6y0UUAb46-NT1rZxdQV906rdOTgpReX1xWEPwMv9ZDGeRvOnh9n4bh5JQimNtEgYKrIkL5NM5poIqYRINM0VUrGiKSMxU0zpvMiULEomUCoJYoVCGLGcpmQArjvvxtXvrfYNX9Wts-EljxMUAtDABeqmo6SrvXe65Btn1sLtOEb8Jx4P8fg-XmCvDsa2WGv1R_7WCsCoA7am0rv_TXzxOOuU3yNheUw</recordid><startdate>202005</startdate><enddate>202005</enddate><creator>McHugh, Grace</creator><creator>Rehman, Andrea M.</creator><creator>Simms, Victoria</creator><creator>Gonzalez‐Martinez, Carmen</creator><creator>Bandason, Tsitsi</creator><creator>Dauya, Ethel</creator><creator>Moyo, Brewster</creator><creator>Mujuru, Hilda</creator><creator>Rylance, Jamie</creator><creator>Sovershaeva, Evgeniya</creator><creator>Weiss, Helen A.</creator><creator>Kranzer, Katharina</creator><creator>Odland, Jon</creator><creator>Ferrand, Rashida A.</creator><creator>Corbett, Elizabeth L</creator><creator>Flaegstad, Trond</creator><creator>Gutteberg, Tore J</creator><creator>Cavanagh, Jorunn Pauline</creator><creator>Majonga, Edith</creator><creator>Dube, Felix</creator><creator>Mhbele, Slee</creator><creator>Yindom, Louis‐Marie</creator><creator>Rowland‐Jones, Sarah</creator><creator>Nicol, Mark</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope></search><sort><creationdate>202005</creationdate><title>Chronic lung disease in children and adolescents with HIV: a case–control study</title><author>McHugh, Grace ; Rehman, Andrea M. ; Simms, Victoria ; Gonzalez‐Martinez, Carmen ; Bandason, Tsitsi ; Dauya, Ethel ; Moyo, Brewster ; Mujuru, Hilda ; Rylance, Jamie ; Sovershaeva, Evgeniya ; Weiss, Helen A. ; Kranzer, Katharina ; Odland, Jon ; Ferrand, Rashida A. ; Corbett, Elizabeth L ; Flaegstad, Trond ; Gutteberg, Tore J ; Cavanagh, Jorunn Pauline ; Majonga, Edith ; Dube, Felix ; Mhbele, Slee ; Yindom, Louis‐Marie ; Rowland‐Jones, Sarah ; Nicol, Mark</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3555-ea460b849f48c9e3acdaa4e59d0d2d576326d6de9b8dcbf6a07c306bd01069573</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adolescents</topic><topic>Africa</topic><topic>Afrique</topic><topic>Age</topic><topic>Antiretroviral agents</topic><topic>Antiretroviral therapy</topic><topic>Bronchodilation</topic><topic>Bronchodilators</topic><topic>Case-Control Studies</topic><topic>Child</topic><topic>Child Health Services</topic><topic>Children</topic><topic>chronic lung disease</topic><topic>Cough</topic><topic>Female</topic><topic>HIV</topic><topic>HIV Infections</topic><topic>HIV-1</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Lung diseases</topic><topic>Lung Diseases - complications</topic><topic>Lung Diseases - epidemiology</topic><topic>maladie pulmonaire chronique</topic><topic>Malawi - epidemiology</topic><topic>Male</topic><topic>Regression analysis</topic><topic>Respiration</topic><topic>Respiratory rate</topic><topic>Salbutamol</topic><topic>Sexually transmitted diseases</topic><topic>Signs and symptoms</topic><topic>STD</topic><topic>Surveys and Questionnaires</topic><topic>Survivors</topic><topic>Teenagers</topic><topic>VIH</topic><topic>Young Adult</topic><topic>Youth</topic><topic>Zimbabwe - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McHugh, Grace</creatorcontrib><creatorcontrib>Rehman, Andrea M.</creatorcontrib><creatorcontrib>Simms, Victoria</creatorcontrib><creatorcontrib>Gonzalez‐Martinez, Carmen</creatorcontrib><creatorcontrib>Bandason, Tsitsi</creatorcontrib><creatorcontrib>Dauya, Ethel</creatorcontrib><creatorcontrib>Moyo, Brewster</creatorcontrib><creatorcontrib>Mujuru, Hilda</creatorcontrib><creatorcontrib>Rylance, Jamie</creatorcontrib><creatorcontrib>Sovershaeva, Evgeniya</creatorcontrib><creatorcontrib>Weiss, Helen A.</creatorcontrib><creatorcontrib>Kranzer, Katharina</creatorcontrib><creatorcontrib>Odland, Jon</creatorcontrib><creatorcontrib>Ferrand, Rashida A.</creatorcontrib><creatorcontrib>Corbett, Elizabeth L</creatorcontrib><creatorcontrib>Flaegstad, Trond</creatorcontrib><creatorcontrib>Gutteberg, Tore J</creatorcontrib><creatorcontrib>Cavanagh, Jorunn Pauline</creatorcontrib><creatorcontrib>Majonga, Edith</creatorcontrib><creatorcontrib>Dube, Felix</creatorcontrib><creatorcontrib>Mhbele, Slee</creatorcontrib><creatorcontrib>Yindom, Louis‐Marie</creatorcontrib><creatorcontrib>Rowland‐Jones, Sarah</creatorcontrib><creatorcontrib>Nicol, Mark</creatorcontrib><creatorcontrib>BREATHE Clinical Trial Team</creatorcontrib><creatorcontrib>the BREATHE Clinical Trial Team</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><jtitle>Tropical medicine & international health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McHugh, Grace</au><au>Rehman, Andrea M.</au><au>Simms, Victoria</au><au>Gonzalez‐Martinez, Carmen</au><au>Bandason, Tsitsi</au><au>Dauya, Ethel</au><au>Moyo, Brewster</au><au>Mujuru, Hilda</au><au>Rylance, Jamie</au><au>Sovershaeva, Evgeniya</au><au>Weiss, Helen A.</au><au>Kranzer, Katharina</au><au>Odland, Jon</au><au>Ferrand, Rashida A.</au><au>Corbett, Elizabeth L</au><au>Flaegstad, Trond</au><au>Gutteberg, Tore J</au><au>Cavanagh, Jorunn Pauline</au><au>Majonga, Edith</au><au>Dube, Felix</au><au>Mhbele, Slee</au><au>Yindom, Louis‐Marie</au><au>Rowland‐Jones, Sarah</au><au>Nicol, Mark</au><aucorp>BREATHE Clinical Trial Team</aucorp><aucorp>the BREATHE Clinical Trial Team</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Chronic lung disease in children and adolescents with HIV: a case–control study</atitle><jtitle>Tropical medicine & international health</jtitle><addtitle>Trop Med Int Health</addtitle><date>2020-05</date><risdate>2020</risdate><volume>25</volume><issue>5</issue><spage>590</spage><epage>599</epage><pages>590-599</pages><issn>1360-2276</issn><eissn>1365-3156</eissn><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.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>31989731</pmid><doi>10.1111/tmi.13375</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1360-2276 |
| ispartof | Tropical medicine & international health, 2020-05, Vol.25 (5), p.590-599 |
| issn | 1360-2276 1365-3156 |
| language | eng |
| recordid | cdi_proquest_journals_2401565069 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Wiley Free Content; Wiley Online Library All Journals |
| subjects | Adolescent Adolescents Africa Afrique Age Antiretroviral agents Antiretroviral therapy Bronchodilation Bronchodilators Case-Control Studies Child Child Health Services Children chronic lung disease Cough Female HIV HIV Infections HIV-1 Human immunodeficiency virus Humans Lung diseases Lung Diseases - complications Lung Diseases - epidemiology maladie pulmonaire chronique Malawi - epidemiology Male Regression analysis Respiration Respiratory rate Salbutamol Sexually transmitted diseases Signs and symptoms STD Surveys and Questionnaires Survivors Teenagers VIH Young Adult Youth Zimbabwe - epidemiology |
| title | Chronic lung disease in children and adolescents with HIV: a case–control study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-11T22%3A49%3A48IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Chronic%20lung%20disease%20in%20children%20and%20adolescents%20with%20HIV:%20a%20case%E2%80%93control%20study&rft.jtitle=Tropical%20medicine%20&%20international%20health&rft.au=McHugh,%20Grace&rft.aucorp=BREATHE%20Clinical%20Trial%20Team&rft.date=2020-05&rft.volume=25&rft.issue=5&rft.spage=590&rft.epage=599&rft.pages=590-599&rft.issn=1360-2276&rft.eissn=1365-3156&rft_id=info:doi/10.1111/tmi.13375&rft_dat=%3Cproquest_cross%3E2401565069%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2401565069&rft_id=info:pmid/31989731&rfr_iscdi=true |