Effect of antiretroviral therapy on longitudinal lung function trends in older children and adolescents with HIV-infection

• DOI: 10.1371/journal.pone.0213556
• Publication Date: 2019-03-21T17:29:47Z
• Authors: Sarah Rylance; Jamie Rylance; Grace McHugh; Edith Majonga; Tsitsi Bandason; Hilda Mujuru; Kusum Nathoo; Sarah Rowland-Jones; Marc Y. R. Henrion; Victoria Simms; Rashida A. Ferrand
• Keywords: Vital capacity

Introduction Chronic respiratory disease is a common cause of morbidity in children with HIV infection. We investigated longitudinal lung function trends among HIV-infected children, to describe the evolution and assess effect anti-retroviral therapy (ART). Methods Prospective follow-up two cohorts aged 6 16 years, Harare, Zimbabwe; one group were ART-naïve at enrolment, other established on ART for median 4.7-years. Standardised spirometric assessments repeated over 2-year period. Forced expiratory volume (FEV1) forced vital capacity (FVC) expressed as Global Lung Initiative defined z-scores (FEV1z FVCz). Linear mixed-effects regression modelling was performed, co-variate parameters evaluated by likelihood ratio comparison. Results included 271 197 ART-established (median age 11 years both groups) incorporating 1144 assessments. Changes FEV1 FVC associated initiation body mass index cohorts. Our models estimate that earlier life could prevent deterioration 0.04 FVCz/year. In cohort, comparison suggested an improvement 0.09 FVCz/year during following treatment initiation, but no evidence this participants ART. Conclusion Early improved nutrition are positively important modifiable factors. An initial growth seen first 2-years although did not appear be sustained beyond timeframe.