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Lung function in HIV infected adolescents on antiretroviral therapy in Cape Town, South Africa PowerPoint Presentation

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Description : Lung function in HIV infected adolescents on antiretroviral therapy in Cape Town, South Africa.

Tags : Pediatrics, Child Health, pediatric practice, pediatrician, health providers, HIV-infected infants, Adolescent Transition, HIV-infected adolescents, antiretroviral therapy

Published on : Jul 18, 2020 | Views : 1479 | Downloads : 0

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Slide 1-

Lung function in HIV infected adolescents on antiretroviral therapy in Cape Town, South Africa Leah Githinji, Di Gray, Landon Myer, Heather Zar MRC unit on Adolescent and Child Health Red Cross War Memorial Children’s Hospital, Department of Paediatrics University of Cape Town Cape Town Antiretroviral Cohort (CTAAC) study
Slide 2-

> 90% HIV infected adolescents live in Sub- Saharan Africa Lung disease is common complication of HIV Limited information on determinants and spectrum of HIV chronic lung disease in adolescents on ART Background
Slide 3-

Aim To describe the spectrum and determinants of lung function in HIV infected adolescents on ART in Cape Town, South Africa Setting: Research Centre for Child and Adolescent Health, Red Cross War Memorial Children’s Hospital
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Methods Cross-sectional analysis from a prospective cohort, recruited 2013-2015 515 HIV infected adolescents, aged 9-14 years on ART for ≥ 6 months Children recruited from primary care clinics and hospital-based ART services across Cape Town 110 uninfected age, sex, ethnicity matched controls Informed consent and assent provided Ethical approval obtained from University of Cape Town
Slide 5-

Lung function in HIV infected adolescents – CTAAC cohort Spirometry N2 multiple breath washout DLCO FOT Bronchodilator response
Slide 6-

Methods: measures Lung function -Spirometry (pre- and post bronchodilator) (Measure of lung volume and airflow) -Obstructive pattern: FEV1/FVC 12% -Single breath diffusion test for CO (measures how well our lungs exchange gases) -Transfer factor for CO (TLCO) forced expiratory volume in 1s (FEV1); forced vital capacity (FVC)
Slide 7-

Methods: measures -N2Multiple breath wash-out test (MBW) (Measures volume that remains in lung after normal breath & non- uniformity of gas distribution in the lungs) -Functional residual capacity (FRC) -Lung clearance index (LCI) -Forced Oscillation Technique (FOT) (non-invasive measure of respiratory mechanics i.e. resistance, compliance & reactance) -Six minute walk test
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Methods Demographic and clinical factors included as covariates to predict lung function Data analysis: STATA 12.0 -Summary statistics -Linear regression to predict lung function parameters
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Results: Participant characteristics
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Comparison of lung function by HIV status * adjusted for age, sex, height
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Comparison of lung function by HIV status Resistance (cmH20.L.s-1), *Compliance (ml/cmH20) multiplied by 1000 ** adjusted for age, sex, height
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Results: Spirometry
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Multivariate analysis: Covariates
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Six minute walk test Ref values (Swiss Cohort BMC 2013) mean arterial pressure (MAP)
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Strengths & Limitations Novel data on lung function in this population Good local access to ART No normative data for several parameters Local HIV-negative controls Focus on lung function Data on lung structure (CT, CXR) being analysed
Slide 16-

Conclusion African HIV infected adolescents on ART have decreased lung volumes, airflow, diffusion capacity and compliance and increased resistance and ventilation homogeneity compared to HIV uninfected adolescents – Generally within normal limits Age, gender, height, past pneumonia and TB were predictors of lung function
Slide 17-

Acknowledgements CTAAC Study participants and staff Sophie Cohen Funding: NICHD R01HD074051 – Additional support from SA-MRC, APCDR Supervisors: H.Zar, D.Gray, L.Myer

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