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Longitudinal Changes in Spirometry in South African Adolescents Perinatally Infected With Human Immunodeficiency Virus Who Are Receiving Antiretroviral Therapy.

正在接受抗逆转录病毒治疗的南非青少年围产期感染人类免疫缺陷病毒的肺活量测定的纵向变化。

  • 影响因子:5.31
  • DOI:10.1093/cid/ciz255
  • 作者列表:"Githinji LN","Gray DM","Hlengwa S","Machemedze T","Zar HJ
  • 发表时间:2020-01-16
Abstract

BACKGROUND:Despite increased access to highly active antiretroviral therapy (HAART), lung disease remains common in human immunodeficiency virus (HIV)-infected (HIV+) adolescents. There is limited information on changes in lung function over time in perinatally HIV+ adolescents on HAART. The objective was to investigate the progression of spirometry findings over 2 years in HIV+ adolescents on HAART in a prospective cohort, the Cape Town Adolescent Antiretroviral Cohort (CTAAC). METHODS:HIV+ adolescents aged 9-14 years, with at least 6 months of HAART, and a comparator group of healthy HIV-uninfected (HIV-), age-matched controls were enrolled in CTAAC. Spirometry and bronchodilator testing were done at baseline, 12 months, and 24 months. Mixed-effect models were used to compute longitudinal changes in lung function. RESULTS:Five hundred fifteen HIV+ adolescents, mean age 12 (standard deviation [SD], 1.6) years, 50.4% male, and 110 HIV- adolescents, mean age 11.8 (SD, 1.8) years, 45.6% male, were tested at baseline; 477 (93%) HIV+ and 102 (93%) HIV- adolescents at 12 months; and 473 (92%) HIV+ and 97 (88%) HIV- adolescents at 24 months. Only 5.4% of the HIV+ adolescents had HIV viral load >10 000 copies/mL at baseline. Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were lower in the HIV+ compared to the HIV- adolescents and tracked with no deterioration or catch-up over 2 years. Previous pulmonary tuberculosis (PTB) or lower respiratory tract infection (LRTI) was significantly associated with reduced FEV1 and FVC (P < .05 for both). CONCLUSIONS:HIV+ adolescents had lower lung function over 2 years than HIV- adolescents. This study highlights the need for lung function surveillance and prevention of LRTIs and PTB in HIV+ adolescents.

摘要

背景: 尽管获得高效抗逆转录病毒治疗 (HAART) 的机会增加,但肺部疾病在人类免疫缺陷病毒 (HIV) 感染 (HIV +) 的青少年中仍然很常见。关于 HAART 上围产期 HIV + 青少年肺功能随时间变化的信息有限。目的是在一项前瞻性队列,即开普敦青少年抗逆转录病毒队列 (CTAAC) 中,调查 HIV + 青少年接受 HAART 治疗 2 年以上肺活量测定结果的进展。 方法: 9-14 岁的 HIV + 青少年,至少 6 个月的 HAART,以及健康 HIV 未感染 (HIV-) 的对照组,年龄匹配的对照入组 CTAAC。在基线、 12 个月和 24 个月时进行肺活量测定和支气管扩张剂检测。混合效应模型用于计算肺功能的纵向变化。 结果: 1.6 名 HIV + 青少年,平均年龄 12 (标准差 [SD],50.4%) 岁,110 名男性,11.8 名 HIV-青少年,平均年龄 1.8 (SD,) 年,45.6% 为男性,基线检测; 477 (93%) HIV + 和 102 (93%)12 个月时的 HIV-青少年; 24 个月时 473 (92%) HIV + 和 97 (88%) HIV-青少年。仅 5.4% 的 HIV + 青少年基线时 HIV 病毒载量> 10 000 拷贝/mL。1 秒用力呼气容积 (FEV1) 和用力肺活量 (FVC) 与 HIV-青少年相比,HIV + 的患病率较低,并且在 2 年内没有恶化或追赶。既往肺结核 (PTB) 或下呼吸道感染 (LRTI) 与 FEV1 和 FVC 降低显著相关 (P <.05)。 结论: HIV + 青少年在 2 年内肺功能低于 HIV 青少年。本研究强调了在 HIV + 青少年中进行肺功能监测和预防 LRTIs 和 PTB 的必要性。

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影响因子:3.94
发表时间:2020-01-15
DOI:10.1016/j.taap.2019.114847
作者列表:["Bernstein DM","Toth B","Rogers RA","Kling DE","Kunzendorf P","Phillips JI","Ernst H"]

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DOI:10.1042/BST20191010
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