1 Department of Pediatrics and Child Health, Red Cross Children's Hospital and Medical Research Council Unit, Child and Adolescent Health, and.
2 Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Ann Am Thorac Soc. 2017 May;14(5):722-729. doi: 10.1513/AnnalsATS.201612-1018OC.
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.
To investigate lung function in HIV-infected adolescents on antiretroviral therapy in the Cape Town Adolescent Antiretroviral Cohort (Cape Town, South Africa).
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.
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/mm. HIV-infected adolescents had significantly lower FEV, FVC, FEV/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.
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.
肺部疾病是 HIV 感染青少年死亡和发病的常见原因，但关于接受抗逆转录病毒治疗的青少年肺部功能障碍的范围，相关信息有限。
在南非开普敦青少年抗逆转录病毒队列（开普敦）中，研究接受抗逆转录病毒治疗的 HIV 感染青少年的肺功能。
共有 515 名南非青少年（年龄 9-14 岁），在接受抗逆转录病毒治疗至少 6 个月后，接受了肺功能基础测试。测试包括肺活量测定、氮多呼吸冲洗、强迫震荡技术、6 分钟步行测试、单次呼吸一氧化碳弥散测试和支气管扩张剂反应测试。还对 110 名年龄和种族匹配的 HIV 未感染者进行了测试。
对于 HIV 感染的青少年（平均[标准差]年龄 12[1.6]岁，52%为男性），抗逆转录病毒治疗的中位（四分位距）持续时间为 7.6（4.6-9.2）年。中位数（四分位距）最低 CD4为 510.5（274-903）细胞/mm。与 HIV 未感染者相比，HIV 感染的青少年的 FEV1、FVC、FEV/FVC、一氧化碳弥散量、呼吸系统顺应性和功能残气量均显著降低（所有关联的 P 值均<0.05）。与 HIV 未感染者相比，HIV 感染的青少年的气道阻力和肺清除指数更高（所有关联的 P 值均<0.05）。尽管差异幅度通常较小，但在调整年龄、性别和身高后，这些差异仍然显著。此外，年龄、性别、身高以及过去下呼吸道感染或肺结核病史与肺功能降低有关。
在接受抗逆转录病毒治疗的南非围产期感染的 HIV 感染青少年中，肺功能低于未感染者。过去的下呼吸道感染或肺结核与肺功能降低有关。
