HIV-related bronchiectasis in children: an emerging spectre in high tuberculosis burden areas
| Autor: | Samuel Malamulele Risenga, Teshni Moodley, Robin J. Green, Piet J. Becker, Refiloe Masekela, Ronald Anderson, Omolemo P. Kitchin |
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| Rok vydání: | 2012 |
| Předmět: |
Pulmonary and Respiratory Medicine
Spirometry medicine.medical_specialty Tuberculosis Adolescent MEDLINE Human immunodeficiency virus (HIV) Developing country HIV Infections Immunologic Tests medicine.disease_cause Risk Assessment South Africa Risk Factors Antiretroviral Therapy Highly Active medicine Humans Intensive care medicine Child Developing Countries Tuberculosis Pulmonary ComputingMilieux_MISCELLANEOUS Bacteriological Techniques Bronchiectasis medicine.diagnostic_test AIDS-Related Opportunistic Infections business.industry Coinfection Sputum Mycobacterium tuberculosis medicine.disease Infectious Diseases Immunology Cytokines Inflammation Mediators Risk assessment business |
| Zdroj: | The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. 16(1) |
| ISSN: | 1815-7920 |
| Popis: | Human immunodeficiency virus (HIV) infected children have an eleven-fold risk of acute lower respiratory tract infection. This places HIV-infected children at risk of airway destruction and bronchiectasis.To study predisposing factors for the development of bronchiectasis in a developing world setting.Children with HIV-related bronchiectasis aged 6-14 years were enrolled. Data were collected on demographics, induced sputum for tuberculosis, respiratory viruses (respiratory syncytial virus), influenza A and B, parainfluenza 1-3, adenovirus and cytomegalovirus), bacteriology and cytokines. Spirometry was performed. Blood samples were obtained for HIV staging, immunoglobulins, immunoCAP®-specific immunoglobulin E (IgE) for common foods and aeroallergens and cytokines.In all, 35 patients were enrolled in the study. Of 161 sputum samples, the predominant organisms cultured were Haemophilus influenzae and parainfluenzae (49%). The median forced expiratory volume in 1 second of all patients was 53%. Interleukin-8 was the predominant cytokine in sputum and serum. The median IgE level was 770 kU/l; however, this did not seem to be related to atopy; 36% were exposed to environmental tobacco smoke, with no correlation between exposure and CD4 count.Children with HIV-related bronchiectasis are diagnosed after the age of 6 years and suffer significant morbidity. Immune stimulation mechanisms in these children are intact despite the level of immunosuppression. |
| Databáze: | OpenAIRE |
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