BACKGROUND: The chest X-ray (CXR) abnormalities of human immunodeficiency virus (HIV)-infected children in low/middle income countries (LMIC's) have not been well studied. OBJECTIVE: To describe the CXR abnormalities and associated clinical/immunological features in HIV-infected South African children. MATERIALS AND METHODS: A prospective study of HIV-infected children who underwent baseline chest radiography and clinical and immunological HIV-staging. CXR abnormalities were stratified as grade 1 (mild) or grade 2 (moderate/severe). Univariate and multiple logistic regression analyses assessed associations between radiological severity and clinical/immunological parameters. RESULTS: Three hundred thirty children (53% male), median age 23.8 months, were included; 303 (92%) had moderate/severe clinical disease and 225 (68%) moderate/severe immune suppression; 52 (16%) had a normal CXR; 169 (51%) had grade 2 CXR abnormalities, manifesting as: confluent opacification (n = 91, 28%), nodules (n = 37, 11%), or nodules with opacification (n = 41, 12%) Grade 2 abnormality was associated with more advanced clinical HIV disease (OR: 6.9; 95% CI: 1.9-25.6), CD4+ less than 20% (OR: 1.8; 95% CI: 1.0-3.0) and age over 24 months (OR: 4.1; 95% CI: 2.1-8.0). CONCLUSION: CXR abnormalities are common in HIV-infected children in LMIC's. The extent of radiological abnormality correlates with age and clinical and immunological severity of HIV-disease.
BACKGROUND: The chest X-ray (CXR) abnormalities of human immunodeficiency virus (HIV)-infectedchildren in low/middle income countries (LMIC's) have not been well studied. OBJECTIVE: To describe the CXR abnormalities and associated clinical/immunological features in HIV-infected South African children. MATERIALS AND METHODS: A prospective study of HIV-infectedchildren who underwent baseline chest radiography and clinical and immunological HIV-staging. CXR abnormalities were stratified as grade 1 (mild) or grade 2 (moderate/severe). Univariate and multiple logistic regression analyses assessed associations between radiological severity and clinical/immunological parameters. RESULTS: Three hundred thirty children (53% male), median age 23.8 months, were included; 303 (92%) had moderate/severe clinical disease and 225 (68%) moderate/severe immune suppression; 52 (16%) had a normal CXR; 169 (51%) had grade 2 CXR abnormalities, manifesting as: confluent opacification (n = 91, 28%), nodules (n = 37, 11%), or nodules with opacification (n = 41, 12%) Grade 2 abnormality was associated with more advanced clinical HIV disease (OR: 6.9; 95% CI: 1.9-25.6), CD4+ less than 20% (OR: 1.8; 95% CI: 1.0-3.0) and age over 24 months (OR: 4.1; 95% CI: 2.1-8.0). CONCLUSION: CXR abnormalities are common in HIV-infectedchildren in LMIC's. The extent of radiological abnormality correlates with age and clinical and immunological severity of HIV-disease.
Authors: Nasreen Mahomed; Bram van Ginneken; Rick H H M Philipsen; Jaime Melendez; David P Moore; Halvani Moodley; Tanusha Sewchuran; Denny Mathew; Shabir A Madhi Journal: Pediatr Radiol Date: 2020-01-13
Authors: Nasreen Mahomed; Nicholas Fancourt; John de Campo; Margaret de Campo; Aliu Akano; Thomas Cherian; Olivia G Cohen; David Greenberg; Stephen Lacey; Neera Kohli; Henrique M Lederman; Shabir A Madhi; Veronica Manduku; Eric D McCollum; Kate Park; Jose Luis Ribo-Aristizabal; Naor Bar-Zeev; Katherine L O'Brien; Kim Mulholland Journal: Pediatr Radiol Date: 2017-09-21