Adolescent age is an independent risk factor for abnormal spirometry among people living with HIV in Kenya
| Autor: | Elizabeth Maleche-Obimbo, Sherry Eskander, Lilian Ndukwe-Wambutsi, T. Eoin West, Michael H. Chung, Engi F. Attia, Christine J. McGrath, Kristina Crothers, Neveen G. El Antouny, Catherine Kiptinness, Celestine K. Mugambi, Anthony Cagle |
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| Rok vydání: | 2018 |
| Předmět: |
Spirometry
Adult Lung Diseases Male medicine.medical_specialty Tuberculosis Adolescent Immunology HIV Infections Logistic regression Adolescent age Article 03 medical and health sciences Young Adult 0302 clinical medicine Risk Factors Internal medicine medicine Prevalence Immunology and Allergy Humans 030212 general & internal medicine Prospective Studies Risk factor Child Lung medicine.diagnostic_test business.industry Age Factors Odds ratio Middle Aged medicine.disease Kenya Confidence interval Infectious Diseases medicine.anatomical_structure Cross-Sectional Studies 030228 respiratory system Female Radiography Thoracic business Tomography X-Ray Computed |
| Zdroj: | AIDS (London, England). 32(10) |
| ISSN: | 1473-5571 |
| Popis: | OBJECTIVES As life expectancy of people living with HIV (PLWH) improves in low-income and middle-income countries (LMICs), the spectrum of HIV-related pulmonary complications may reflect a greater burden of chronic lung diseases as in high-income countries. We determined whether the risk of abnormal spirometry was greater among adolescent compared with adult PLWH at the Coptic Hope Center for Infectious Diseases in Nairobi, Kenya, and evaluated the role of other cofactors for abnormal spirometry. DESIGN We prospectively enrolled adolescent and adult PLWH for this cross-sectional study. METHODS Data collection included standardized questionnaires, clinical assessment, and prebronchodilator and postbronchodilator spirometry. Adolescents additionally underwent noncontrast chest computed tomography. Multivariable logistic regression determined associations of adolescent age with abnormal spirometry, adjusting for cofactors. RESULTS Of 427 PLWH, 21 (40%) adolescents and 64 (17%) adults had abnormal spirometry. Among adolescents, 80% had abnormal chest CTs, and 79% had at least one respiratory symptom. Adolescent age (adjusted odds ratio 3.22; 95% confidence interval 1.48-6.98) was independently associated with abnormal spirometry, adjusting for recent CD4, HIV clinical stage, low BMI, indoor kerosene use, smoking pack-years, and prior pulmonary tuberculosis. Additional important cofactors for abnormal spirometry included prior pulmonary tuberculosis (3.15; 1.70-5.58), kerosene use (1.77; 1.04-3.04) and smoking pack-years (1.05; 1.00-1.10). Adolescent age, prior pulmonary tuberculosis, and smoking pack-years were significantly associated with airflow limitation. CONCLUSION Adolescent age was independently associated with increased risk of abnormal spirometry, particularly airflow limitation. Studies to improve prevention, detection, and management of chronic lung disease across the lifespan among PLWH are needed in LMICs. |
| Databáze: | OpenAIRE |
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