Grace McHugh1, Andrea M Rehman2, Victoria Simms2, Carmen Gonzalez-Martinez3, Tsitsi Bandason1, Ethel Dauya1, Brewster Moyo3, Hilda Mujuru4, Jamie Rylance3, Evgeniya Sovershaeva5, Helen A Weiss2, Katharina Kranzer1,6,7, Jon Odland5,8, Rashida A Ferrand1,7. 1. Biomedical Research and Training Institute, Harare, Zimbabwe. 2. MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK. 3. Malawi-Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi. 4. Department of Paediatrics, University of Zimbabwe, Harare, Zimbabwe. 5. Arctic University of Norway, Tromsø, Norway. 6. National TB Reference Laboratory, Research Centre Borstel, Borstel, Germany. 7. Clinical Research Unit, London School of Hygiene and Tropical Medicine, London, UK. 8. Norwegian University of Science and Technology, Trondheim, Norway.
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.
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.
Authors: Christi Jackson; Andrea M Rehman; Grace McHugh; Carmen Gonzalez-Martinez; Lucky G Ngwira; Tsitsi Bandason; Hilda Mujuru; Jon O Odland; Elizabeth L Corbett; Rashida A Ferrand; Victoria Simms Journal: BMC Pediatr Date: 2022-06-11 Impact factor: 2.567
Authors: Regina E Abotsi; Mark P Nicol; Grace McHugh; Victoria Simms; Andrea M Rehman; Charmaine Barthus; Slindile Mbhele; Brewster W Moyo; Lucky G Ngwira; Hilda Mujuru; Beauty Makamure; Justin Mayini; Jon Ø Odland; Rashida A Ferrand; Felix S Dube Journal: BMC Infect Dis Date: 2021-02-25 Impact factor: 3.090
Authors: Rashida A Ferrand; Grace McHugh; Andrea M Rehman; Hilda Mujuru; Victoria Simms; Edith D Majonga; Mark P Nicol; Trond Flaegstad; Tore J Gutteberg; Carmen Gonzalez-Martinez; Elizabeth L Corbett; Sarah L Rowland-Jones; Katharina Kranzer; Helen A Weiss; Jon O Odland Journal: JAMA Netw Open Date: 2020-12-01
Authors: Dan Hameiri-Bowen; Evgeniya Sovershaeva; Trond Flaegstad; Tore Jarl Gutteberg; Lucky Gift Ngwira; Victoria Simms; Andrea M Rehman; Grace Mchugh; Tsitsi Bandason; Rashida Abbas Ferrand; Sarah Rowland-Jones; Louis-Marie Yindom Journal: AIDS Date: 2021-09-01 Impact factor: 4.632