A scoping review of lung function in children and adolescents living with HIV in the era of antiretroviral treatment

Abstract

Background: Human immunodeficiency virus (HIV) in children and adolescents remains an important health challenge in many countries and is commonly associated with lung disease. The introduction of antiretroviral therapy (ART) has greatly improved survival but chronic lung disease is a common ongoing challenge.We conducted a scoping review of studies that have reported lung function in school-aged children and adolescents living with HIV.Methods: A systematic literature search was performed by searching Medline, Embase, and PubMed databases, limited to articles published between 2011 and 2021 in English language. Inclusion criteria were studies involving participants living with HIV aged 5-18 years and having spirometry data. The primary outcome was lung function as measured by spirometry.Results: Twenty-one studies were included in the review. Most study participants were living in the sub-Saharan African region. The prevalence of reduced forced expiratory volume in 1 s (FEV 1 ) ranged from 25.3% to 73% across studies, reduced forced vital capacity (FVC) ranged from 10% to 42% and reduced FEV 1 /FVC ranged from 3% to 26%. The mean z-score of FEV 1 ranged from −2.19 to −0.73, mean zFEV 1 /FVC ranged from −0.74 to 0.2, and mean FVC ranged from −1.86 to −0.63. Conclusion:There is a high prevalence of lung function impairment in children and adolescents living with HIV, which persists in the ART era. Further studies are needed of interventions that might improve lung function in these vulnerable populations.

Prevalence, clinical presentation and factors associated with chronic lung disease among children and adolescents living with HIV in Kenya

“…As immune depletion can progress rapidly in perinatally HIV-infected infants, many are still diagnosed at an advanced stage of HIV disease having already experienced recurrent severe opportunistic infections such as pneumonia or tuberculosis (TB) [ 2 – 5 ]. Once on effective antiretroviral therapy (ART), recurrent and severe infections become relatively infrequent [ 6 – 7 ] and survival greatly improves but there may be residual organ damage [ 2 , 8 – 11 , 18 ]. The lung is the commonest site of infection in untreated HIV disease, and therefore the organ most vulnerable to damage and long-term sequelae [ 2 , 12 – 14 ].…”