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Bronchiectasis and other chronic lung diseases in adolescents living with HIV.
- Source :
-
Current opinion in infectious diseases [Curr Opin Infect Dis] 2017 Feb; Vol. 30 (1), pp. 21-30. - Publication Year :
- 2017
-
Abstract
- Purpose of Review: The incidence of pulmonary infections has declined dramatically with improved access to antiretroviral therapy (ART) and cotrimoxazole prophylaxis, but chronic lung disease (CLD) is an increasingly recognized but poorly understood complication in adolescents with perinatally acquired HIV.<br />Recent Findings: There is a high prevalence of chronic respiratory symptoms, abnormal spirometry and chest radiographic abnormalities among HIV-infected adolescents in sub-Saharan Africa, wherein 90% of the world's HIV-infected children live. The incidence of lymphocytic interstitial pneumonitis, the most common cause of CLD in the pre-ART era, has declined with increased ART access. Small airways disease, particularly constrictive obliterative bronchiolitis and bronchiectasis, are emerging as leading causes of CLD among HIV-infected adolescents in low-income and middle-income countries. Asthma may be more common in high-income settings. Likely risk factors for CLD include recurrent pulmonary infections, air pollution, HIV-related immune dysfunction, and untreated HIV infection, particularly during critical stages of lung development.<br />Summary: Globally, the importance of HIV-associated CLD as a cause of morbidity and mortality is increasing, especially as survival has improved dramatically with ART and growing numbers of children living with HIV enter adolescence. Further research is urgently needed to elucidate the natural history and pathogenesis of CLD, and to determine optimal screening, diagnostic and treatment strategies.
- Subjects :
- Adolescent
Africa South of the Sahara epidemiology
Bronchiectasis epidemiology
Bronchiectasis etiology
Chronic Disease
Humans
Lung Diseases etiology
Lung Diseases, Interstitial epidemiology
Lung Diseases, Interstitial etiology
Pulmonary Disease, Chronic Obstructive epidemiology
Pulmonary Disease, Chronic Obstructive etiology
HIV Infections complications
Lung Diseases epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1473-6527
- Volume :
- 30
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Current opinion in infectious diseases
- Publication Type :
- Academic Journal
- Accession number :
- 27753690
- Full Text :
- https://doi.org/10.1097/QCO.0000000000000325